Provider Demographics
NPI:1467860387
Name:WRIGHTSVILLE SERVICES, LLC
Entity Type:Organization
Organization Name:WRIGHTSVILLE SERVICES, LLC
Other - Org Name:THE RANCH PENNSYLVANIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR DIRECTOR RCM
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLESDEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, CHC, CHPC
Authorized Official - Phone:615-510-3078
Mailing Address - Street 1:PO BOX 670624
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-0624
Mailing Address - Country:US
Mailing Address - Phone:615-567-7282
Mailing Address - Fax:615-807-2931
Practice Address - Street 1:1166 HILTS ROAD
Practice Address - Street 2:
Practice Address - City:WRIGHTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17368
Practice Address - Country:US
Practice Address - Phone:717-225-3906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA331950323P00000X
PA677079324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility