Organization
WYOMING VALLEY ALCOHOL AND DRUG SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HARLEN MA (CEO)
(570) 820-8888
Entity
Organization
Contact information
Practice address
480 PIERCE ST, 316-317, KINGSTON, PA 18704-5512
(570) 820-8888
Mailing address
437 N MAIN ST, WILKES BARRE, PA 18705-1613
(570) 820-8888
(570) 820-8899
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
407063
PA
Other
Enumeration date
05/26/2016
Last updated
05/26/2016
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