Organization
THE COMMUNITY INTERVENTION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA QUINN FINNERTY (DIRECTOR)
(570) 342-4298
Entity
Organization
Contact information
Practice address
445 N 6TH AVE, SCRANTON, PA 18503-2101
(570) 342-4298
(570) 343-2804
Mailing address
445 N 6TH AVE, SCRANTON, PA 18503-2101
(570) 342-4298
(570) 343-2804
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1016532920002
CCBH GRP
PA
Enumeration date
02/22/2007
Last updated
05/06/2015
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