Provider Demographics
NPI:1487196457
Name:CHI ST. JOSEPH CHILDREN'S HEALTH
Entity Type:Organization
Organization Name:CHI ST. JOSEPH CHILDREN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:K
Authorized Official - Last Name:GOROPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-397-7625
Mailing Address - Street 1:1929 LINCOLN HWY E STE 150
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3685
Mailing Address - Country:US
Mailing Address - Phone:717-397-7625
Mailing Address - Fax:717-397-6057
Practice Address - Street 1:1929 LINCOLN HWY E STE 100
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3347
Practice Address - Country:US
Practice Address - Phone:717-397-7625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC HEALTH INITIATIVES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty