| Wyoming Valley Alcohol & Drug Services, Inc | |
|
49 South Main St. Pittston PA 18640 | |
| (570) 820-8888 | |
| (570) 820-8899 |
| Full Name | Wyoming Valley Alcohol & Drug Services, Inc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 49 South Main St., Pittston, Pennsylvania |
| Authorized Official Name and Position | Jason Harlen (CEO) |
| Authorized Official Contact | 5708208888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wyoming Valley Alcohol & Drug Services, Inc 437 North Main St. Wilkes Barre PA 18705 Ph: (570) 820-8888 | Wyoming Valley Alcohol & Drug Services, Inc 49 South Main St. Pittston PA 18640 Ph: (570) 820-8888 |
| NPI Number | 1558532671 |
|---|---|
| Provider Enumeration Date | 03/17/2008 |
| Last Update Date | 01/28/2020 |
| Certification Date | 01/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558532671 | NPI | - | NPPES |
| 401216 | Other | PA | DEPARTMENT OF HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 401216 (Pennsylvania) | Primary |
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