WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC


Address: 562 Wyoming Ave, Kingston, PA 18704-3721
Phone: 5705523700

WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC (NPI# 1992931893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992931893
Entity Type Organization
Organization Name WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC
Other Organization Name CHOICES PROGRAM OF WYOMING VALLEY
Practice Address 562 Wyoming Ave
Kingston
PA 18704-3721
Practice Telephone 5705523700
Practice Fax Number 5705523733
Mailing Telephone 5705523700
Mailing Fax Number 5705523733
Enumeration Date 2009-06-05
Last Update Date 2009-06-05
Authorized Official Name LAURIE HOLTSFORD (DIRECTOR)
Authorized Official Telephone 6154657466
Is Organization Subpart Y
Parent Organization Name WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
407030 PA Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Choices Program of Wyoming Valley Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1093070583 Wilkes Barre Behavioral Hospital Company LLC Community Based Residential Treatment Facility, Mental Illness 76 S Dawes Ave, Kingston, PA 18704-5710 2012-07-10
1649535139 Wilkes Barre Behavioral Hospital Company LLC Community Based Residential Treatment Facility, Mental Illness 3504 Bear Creek Blvd, Bear Creek Township, PA 18702-9760 2012-07-10
1073842936 Wilkes Barre Behavioral Hospital Company LLC Registered Nurse 562 Wyoming Ave, Kingston, PA 18704-3721 2009-12-23
1982835484 Wilkes Barre Behavioral Hospital Company LLC Case Management 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 2009-07-31
1669608477 Wilkes Barre Behavioral Hospital Company LLC Clinic/Center 99 Bridge St, Tunkhannock, PA 18657-1303 2009-06-08
1114153921 Wilkes Barre Behavioral Hospital Company LLC Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2009-06-08
1477789287 Wilkes Barre Behavioral Hospital Company LLC Case Management 562 Wyoming Ave, Kingston, PA 18704-3721 2009-06-08
1386870194 Wilkes Barre Behavioral Hospital Company LLC Case Management 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 2009-06-08
1376779181 Wilkes Barre Behavioral Hospital Company LLC Clinic/Center 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 2009-06-08
1568698371 Wilkes Barre Behavioral Hospital Company LLC Clinic/Center 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 2009-06-08

Office Location

Street Address 562 WYOMING AVE
City KINGSTON
State PA
Zip Code 18704-3721

Providers in the same location

NPI Name Taxonomy Address Enumeration
1780683417 David Liskov Psychiatry & Neurology 562 Wyoming Ave, Kingston, PA 18704-3721 2005-07-15
1376186064 Brent Smith Registered Nurse 562 Wyoming Ave, Kingston, PA 18704-3721 2019-10-24
1275812661 Roseanne P Pace Counselor 562 Wyoming Ave, Kingston, PA 18704-3721 2011-08-16
1609172170 Brittany Bahner Counselor 562 Wyoming Ave, Kingston, PA 18704-3721 2011-02-01
1528368826 Mary Repasky Counselor 562 Wyoming Ave, Choices Program of Wyoming Valley, Kingston, PA 18704 2010-11-02
1073842936 Wilkes Barre Behavioral Hospital Company LLC Registered Nurse 562 Wyoming Ave, Kingston, PA 18704-3721 2009-12-23
1285862409 David Liskov, Md Psychiatry & Neurology 562 Wyoming Ave, Kingston, PA 18704-3721 2009-06-25
1013144211 Md.mushfiqur Rahman Psychiatry & Neurology 562 Wyoming Ave, First Hospital, Kingston, PA 18704-3721 2009-06-15
1114153921 Wilkes Barre Behavioral Hospital Company LLC Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2009-06-08
1477789287 Wilkes Barre Behavioral Hospital Company LLC Case Management 562 Wyoming Ave, Kingston, PA 18704-3721 2009-06-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013557552 Millmark Health Inc. Psychiatry & Neurology 511 Pierce Street, Kingston, PA 18704 2020-01-13
1427550334 Michael Anthony Waltich Military Health Care Provider 82 Cooper Street, Pringle, PA 18704 2018-03-06
1376088435 Jae LLC Massage Therapist 512 Northhampton Street, Edwardsville, PA 18704 2016-12-28
1306278288 Mohammad Khaled Tashkandi Internal Medicine 490 Northampton St Ste 1, Edwardsville, PA 18704 2013-08-02
1396180014 Sammie Craven IIi Pharmacist 96 1st Avenue, Kingston, PA 18704 2013-05-08
1447693114 Catherine Mary Harding Nurse Practitioner 141 South Maple Ave, Kingston, PA 18704 2013-04-12
1861781403 Jennifer Ann Richards Pharmacist 22 West Side Mall, Edwardsville, PA 18704 2011-04-05
1558512772 Jolon Theresa Sherin Speech-Language Pathologist 1825 Sans Souci Highway, Hanover, PA 18704 2008-10-07
1932361102 Kari Ann Pietralczyk Audiologist 190 Welles Street, Forty-fort, PA 18704 2008-06-30
1467584151 John Christopher Storti Chiropractor 180 United Penn Plaza, Kingston, PA 18704 2007-03-09
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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043435563 Port Gamble S'klallam Orca Pride Clinic/Center 32014 Little Boston Rd Ne, Kingston, WA 98346-9734 2007-04-17
1346464831 Lisa Kohli Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2007-04-13
1841414349 Mallory Ward Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2007-04-13
1750506143 Nadia M Zukosky Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2007-04-13
1134344542 Ethellean Mcneil Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2007-04-13
1275654956 Luzerne Wyoming Co Mhc#1 Clinic/Center 562 Wyoming Ave, Kingston, PA 18704-3721 2007-04-02
1578622973 Port Gamble S'klallam Chemical Dependency Program Clinic/Center 32014 Little Boston Rd Ne, Kingston, WA 98346-9734 2006-12-08

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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
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Competitor

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City KINGSTON
Zip Code 18704

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Dataset Information

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.

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