Organization
ROSE RESILIENCY CENTER
Active
Parent organization
SECOND HAVEN SERVICES FOR YOUTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
SECOND HAVEN SERVICES FOR YOUTH
Authorized official
MR. WILLIAM FREEMAN IV MBA (EXECUTIVE DIRECTOR)
(866) 343-5509
Entity
Organization
Contact information
Practice address
2557 ROUTE 940, SUITE 102, POCONO SUMMIT, PA 18346
(866) 343-5509
(570) 839-5392
Mailing address
PO BOX 329, MOUNT POCONO, PA 18344-0329
(866) 343-5509
(570) 839-5392
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
MD037460L
PA
Other
Enumeration date
05/02/2013
Last updated
05/02/2013
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