| Luzerne Intermediate Unit #18 | |
|
368 Tioga Ave Kingston PA 18704-5117 | |
| (570) 718-4669 | |
| Not Available |
| Full Name | Luzerne Intermediate Unit #18 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 368 Tioga Ave, Kingston, Pennsylvania |
| Authorized Official Name and Position | Jennifer Lynn Runquist (DIRECTOR OF BEHAVIORAL HEALTH) |
| Authorized Official Contact | 5708253928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luzerne Intermediate Unit #18 368 Tioga Ave Kingston PA 18704-5117 Ph: (570) 718-4669 | Luzerne Intermediate Unit #18 368 Tioga Ave Kingston PA 18704-5117 Ph: (570) 718-4669 |
| NPI Number | 1164557716 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164557716 | NPI | - | NPPES |
| 1000036690008 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 217190 (Pennsylvania) | Primary |
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