Organization
SHARED SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY HYSON LSW (REGIONAL DIRECTOR)
(570) 286-4982
Entity
Organization
Contact information
Practice address
218 BRIDGE AVE, SUNBURY, PA 17801-1006
(570) 286-4982
(570) 286-4984
Mailing address
218 BRIDGE AVE, SUNBURY, PA 17801-1006
(570) 286-4982
(570) 286-4984
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
PA
Other
Enumeration date
04/20/2011
Last updated
04/20/2011
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