Provider Demographics
NPI:1710985635
Name:DISCOVERY HOUSE CU, LLC
Entity type:Organization
Organization Name:DISCOVERY HOUSE CU, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP & SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-716-9335
Mailing Address - Street 1:6183 PASEO DEL NORTE STE 200
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1151
Mailing Address - Country:US
Mailing Address - Phone:156-861-6000
Mailing Address - Fax:
Practice Address - Street 1:214 AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-7022
Practice Address - Country:US
Practice Address - Phone:814-768-7575
Practice Address - Fax:814-768-9754
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACADIA HEALTHCARE COMPANY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-13
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA177102261QR0405X, 261Q00000X, 261QM2800X
251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251B00000XAgenciesCase Management
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA348401OtherVALUE OPTIONS
PA0019345680001Medicaid