Organization
PYRAMID HEALTHCARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON E HENDRICKS (CEO)
(814) 940-0407
Entity
Organization
Contact information
Practice address
420 SUPREME CT, EAST STROUDSBURG, PA 18302-6800
(814) 940-0407
Mailing address
1894 PLANK RD, PO BOX 967, DUNCANSVILLE, PA 16635-8380
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
457040
PA
324500000X
Substance Abuse Rehabilitation Facility
Primary
457040
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007625050079
—
PA
01
—
457040
LICENSE NUMBER
PA
Enumeration date
08/02/2013
Last updated
04/10/2024
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