Organization
GOODKNIGHT THE CLUBHOUSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE R GOODMAN SR. (CEO)
(484) 769-3028
Entity
Organization
Contact information
Practice address
645 WALNUT ST., READING, PA 19601
(484) 755-5980
Mailing address
996 BAYWOOD AVE., WERNERSVILLE, PA 19565
(484) 769-3028
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
04/06/2021
Last updated
06/24/2021
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