| Colonial Intermediate Unit 20 | |
|
940 Twin Lakes Rd Shohola PA 18458-4405 | |
| (610) 515-6439 | |
| Not Available |
| Full Name | Colonial Intermediate Unit 20 |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 940 Twin Lakes Rd, Shohola, Pennsylvania |
| Authorized Official Name and Position | Jen Kosiba (MEDICAL BILLING/RESOLVE OUTPATIENT) |
| Authorized Official Contact | 6105156439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Intermediate Unit 20 6 Danforth Dr Easton PA 18045-7820 Ph: (610) 515-6439 | Colonial Intermediate Unit 20 940 Twin Lakes Rd Shohola PA 18458-4405 Ph: (610) 515-6439 |
| NPI Number | 1417605452 |
|---|---|
| Provider Enumeration Date | 03/17/2022 |
| Last Update Date | 03/17/2022 |
| Certification Date | 03/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417605452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |