Basic Information
| Provider Information | |||||||||
| NPI: | 1164700373 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOLY SPIRIT HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 N 21ST ST | ||||||||
| Address2: | |||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170112204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177632100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3 FLOWERS DR | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170501701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176121839 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2011 | ||||||||
| LastUpdateDate: | 07/22/2011 | ||||||||
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| AuthorizedOfficialLastName: | MIRILLO | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINICAL OPERATIONS COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 7177632245 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.