Organization
DRUG AND ALCOHOL TREATMENT SERV
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN J. MCLAUGHLIN LSW (EXECUTIVE DIRECTOR)
(570) 344-3877
Entity
Organization
Contact information
Practice address
441 WYOMING AVENUE, SCRANTON, PA 18503-1800
(570) 344-3877
(570) 344-1090
Mailing address
116 N WASHINGTON AVE, SUITE 3A, SCRANTON, PA 18503-1800
(570) 961-1997
(570) 344-9632
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093511
FPH ID #
PA
05
—
1007465840002
—
PA
01
—
4544717
AETNA ID#
PA
01
—
90006
GEISINGER HEALTH ID#
PA
01
—
999022
BCBS ID #
PA
Enumeration date
02/22/2006
Last updated
06/15/2010
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