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Organization
PENNSYLVANIA ASSOCIATES, LLC
Active
Organization
PENNSYLVANIA ASSOCIATES, LLC
Active
Other names
Mount Pocono Medical
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
1151 MOUNT POCONO BLVD, SUITE 3, MOUNT POCONO, PA 18344
(570) 839-7246
(570) 839-7248
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
457036
PA
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
457036
PA DEPARTMENT OF HEALTH LICENSE NUMBER
PA
Enumeration date
01/13/2010
Last updated
07/23/2026
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