Organization
COUNTY OF WAYNE
Active
Other names
Wayne County MHMR
Organization subpart
No
Provider details
NPI number
Authorized official
MARGARET ENNIS (MHMR ADMINISTRATOR)
(570) 253-9200
Entity
Organization
Contact information
Practice address
648 PARK ST, SUITE A, HONESDALE, PA 18431-1446
(570) 253-9200
Mailing address
648 PARK ST, SUITE A, HONESDALE, PA 18431-1446
(570) 253-9200
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10017310820002
—
PA
Enumeration date
02/02/2007
Last updated
08/22/2020
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