Organization
WAKEFIELD COTTAGE LLC
Active
Organization
WAKEFIELD COTTAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE M BROWN (CEO)
(570) 722-8883
Entity
Organization
Contact information
Practice address
4 NASH TRAIL, ALBRIGHTSVILLE, PA 18210-0314
(570) 722-8883
Mailing address
4 NASH TRAIL, PO BOX 314, ALBRIGHTSVILLE, PA 18210
(570) 722-8883
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
207590
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100002859
PROMISE
PA
Enumeration date
05/21/2009
Last updated
05/21/2009
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