Luzerne Wyoming Co Mhc#1

NPI 1275654956 - Clinic/Center - 261QR0405X

NPI Details
NPI 1275654956
Enumeration Date 04/02/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARY EDITH MARY
Position DIRECTOR OF ALL CHOICES PROGRAMS
Phone (570) 552-3700
Fax
Practice Location
562 WYOMING AVE
KINGSTON PA, 18704-3721, US
Phone (570) 552-3700
Fax
Business Location
RR 1 BOX 282C
WAPWALLOPEN PA, 18660-9771, US
Phone (570) 417-2830
Fax
Toxanomy
Taxonomy Code 261QR0405X
License State Pennsylvania
License Number CW014765
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According to our database, Luzerne Wyoming Co Mhc#1 NPI is 1275654956, taxonomy code is 261QR0405X and license number is CW014765, license state is located at Pennsylvania. Luzerne Wyoming Co Mhc#1 physically located at 562 Wyoming Ave, Kingston PA, 18704-3721. NPI Number 1033115704 has the healthcare provider type.

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1275654956 NPI number is provided on an as is basis without warranty of any kind. 1275654956 is maintained by the National Plan & Provider Enumeration System. The contents of Luzerne Wyoming Co Mhc#1 are for informational purposes only.