MAIN LINE TREATMENT, LLC (NPI# 1083172803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083172803 |
Entity Type | Organization |
Organization Name | MAIN LINE TREATMENT, LLC |
Other Organization Name | MAIN LINE TREATMENT, LLC |
Practice Address |
1410 Russell Rd Ste 205 Paoli PA 19301-1200 |
Mailing Address |
355 Highland Ave Berwyn PA 19312-1600 |
Practice Telephone | 6104074666 |
Practice Fax Number | 6104074666 |
Mailing Telephone | 6104169444 |
Mailing Fax Number | 6104074666 |
Enumeration Date | 2019-03-11 |
Last Update Date | 2019-03-16 |
Authorized Official Name | MR. TIMOTHY P BOYLE (PRESIDENT) |
Authorized Official Telephone | 6104169444 |
Authorized Official Credential | LPC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Main Line Treatment, LLC | Doing Business As Name - Organization |
Street Address |
1410 RUSSELL RD STE 205 |
City | PAOLI |
State | PA |
Zip Code | 19301-1200 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730291865 | Timothy P Boyle | Counselor | 1410 Russell Rd Ste 205, Paoli, PA 19301-1200 | 2006-08-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588280333 | Mary Callery | Physical Therapy Assistant | 16 Industrial Blvd., Ste. 101, Paoli, PA 19301 | 2020-06-17 |
1871097519 | Daniel Malloy-good | Social Worker | 45 Darby Rd Ste E4, Paoli, PA 19301 | 2018-03-19 |
1306354774 | Patricia Obilo-azandegbe | Counselor | 30 S Valley Rd Ste 101, Paoli, PA 19301 | 2018-01-18 |
1275992877 | Jessica Bernard | Physical Therapist | 40 Darby Rd Ste 1, Paoli, PA 19301 | 2016-02-11 |
1730576364 | Ushma Sheth | Podiatrist | 250 W Lancaster Ave Ste 225, Paoli, PA 19301 | 2015-04-21 |
1619371432 | Miriam Leslie Brewer | Physical Therapist | 195 W Lancaster Ave #3, Paoli, PA 19301 | 2014-10-22 |
1447665393 | Matthew Rementer | Podiatrist | 254 West Lancaster Ave, Paoli, PA 19301 | 2014-06-29 |
1720490915 | Edward Anthony Romero | Surgery | 255 W Lancaster Ave Ste 332, Paoli, PA 19301 | 2014-05-22 |
1285053421 | Jose Ethan Pulido | Urology | 2 Industrial Blvd Bldg C Ste 120, Paoli, PA 19301 | 2014-04-15 |
1093065849 | Kathleen M Canfield | Physician Assistant | 11 Industrial Blvd., Ste 204, Paoli Pointe Med. Office Bldg, Paoli, PA 19301 | 2012-09-19 |
Find all providers in zip 19301 |
Taxonomy Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255409827 | Rehab Management Inc | Clinic/Center | 1440 Russell Rd, Paoli, PA 19301-1236 | 2006-12-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841816204 | Source Behavioral Health Services, LLC | Clinic/Center | 301 Oxford Valley Rd Ste 1302, Yardley, PA 19067-7706 | 2020-06-22 |
1780218594 | Davis Archway Centers for Addiction Treatment, Inc. | Clinic/Center | 114 Courson Ln, Emlenton, PA 16373-2502 | 2020-03-02 |
1871125625 | New Hope Community Medical Care LLC | Clinic/Center | 2602 W 9th St Ste 101, Chester, PA 19013-2089 | 2020-02-10 |
1528699931 | Caron Outpatient Services, LLC | Clinic/Center | 401 Plymouth Rd Ste 325, Plymouth Meeting, PA 19462-1650 | 2020-02-04 |
1124658331 | White Oak Wellness | Clinic/Center | 1966 Lincoln Way Ste 100, White Oak, PA 15131-2416 | 2020-01-16 |
1518517283 | Peace Valley Recovery | Clinic/Center | 5230 York Rd, Doylestown, PA 18902-1736 | 2019-09-16 |
1841853256 | Trinity Recovery LLP | Clinic/Center | 1311 E State St, Sharon, PA 16146-3246 | 2019-04-22 |
1861950909 | Advanced Treatment Centers LLC | Clinic/Center | 60 Abele Rd Ste 1103, Bridgeville, PA 15017-3467 | 2019-03-07 |
1467918722 | Melissa Francomacaro | Clinic/Center | 1035 W Walnut St Apt 2, Allentown, PA 18102-4847 | 2019-02-12 |
1205390325 | Pyramid Health Care Inc. | Clinic/Center | 100 Upper Demunds Rd, Dallas, PA 18612-8811 | 2019-01-23 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.