Organization
TREHAB DRUG AND ALCOHOL OUTPATIENT PROGRAM
Active
Organization
TREHAB DRUG AND ALCOHOL OUTPATIENT PROGRAM
Active
Other names
Trehab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS PHELPS (PROGRAM DIRECTOR)
(570) 278-5227
Entity
Organization
Contact information
Practice address
36 PUBLIC AVE, BOX 366, MONTROSE, PA 18801-1220
(570) 278-3338
Mailing address
36 PUBLIC AVE, 2ND FLOOR, MONTROSE, PA 18801-1220
(570) 278-3338
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
H6526601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100-730-1450005
MEDICAL ASSISTANCE
PA
01
—
100-730-1450006
MEDICAL ASSISTANCE
PA
01
—
100-730-1450007
MEDICAL ASSISTANCE
PA
Enumeration date
11/15/2007
Last updated
09/21/2015
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