Provider Demographics
NPI:1548381155
Name:RAMSBOTTOM CENTER, INC.
Entity Type:Organization
Organization Name:RAMSBOTTOM CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-817-1400
Mailing Address - Street 1:800 EAST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-3278
Mailing Address - Country:US
Mailing Address - Phone:814-817-1400
Mailing Address - Fax:814-817-1447
Practice Address - Street 1:800 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-3278
Practice Address - Country:US
Practice Address - Phone:814-817-1400
Practice Address - Fax:814-817-1447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA335610251K00000X
251K00000X
PA844020315P00000X
PA425250320800000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No251K00000XAgenciesPublic Health or Welfare
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000012990009Medicare ID - Type UnspecifiedRAMSBOTTOM