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Organization
HEALTH POCONOS, INC
Active
Organization
HEALTH POCONOS, INC
Active
Other names
Riverside Rehabilitation Center II
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MAASSEN (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization
Contact information
Practice address
100 COMMUNITY DR, 105, TOBYHANNA, PA 18466-8985
(570) 839-9975
(570) 839-9274
Mailing address
100 COMMUNITY DR, 207, TOBYHANNA, PA 18466-8985
(570) 839-9975
(570) 839-9274
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
394532
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001467795
—
PA
01
—
0510083000
IBC
PA
01
—
2451453209
GEISINGER
PA
01
—
2Y4263
HEALTHNET
PA
01
—
50004997
CAPITAL BLUE CROSS
PA
01
—
543451
AETNA
PA
01
—
81386
THREE RIVERS
PA
01
—
E56832
AMERIHEALTH
PA
01
—
RI556832
BLUE SHIELD #
PA
Enumeration date
11/18/2005
Last updated
06/29/2012
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