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).
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 |
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 Name | Type Code |
---|---|
Choices Program of Wyoming Valley | Doing Business As Name - Organization |
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 |
Street Address |
562 WYOMING AVE |
City | KINGSTON |
State | PA |
Zip Code | 18704-3721 |
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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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 Code | 261QR0405X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Rehabilitation, Substance Use Disorder |
Definition to come... |
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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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 |
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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.