Organization
ST. JOSEPH'S CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GORDON (VICE PRESIDENT CFO)
(570) 963-1273
Entity
Organization
Contact information
Practice address
2010 ADAMS AVE, SCRANTON, PA 18509-1508
(570) 342-8379
(570) 963-1286
Mailing address
2010 ADAMS AVE, SCRANTON, PA 18509-1508
(570) 342-8379
(570) 963-1286
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
PA
225800000X
Recreation Therapist
—
PA
225A00000X
Music Therapist
—
PA
225X00000X
Occupational Therapist
—
PA
235Z00000X
Speech-Language Pathologist
—
PA
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
—
PA
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
PA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
PA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000013880001
—
PA
05
—
1000013880031
—
PA
05
—
1000013880034
—
PA
05
—
1000013880038
—
PA
05
—
1000013880040
—
PA
05
—
1000013880046
—
PA
05
—
1000013880047
—
PA
05
—
1000013880048
—
PA
05
—
1000013880049
—
PA
05
—
1000013880050
—
PA
05
—
1000013880054
—
PA
05
—
1000013880055
—
PA
05
—
1000013880056
—
PA
05
—
1000013880057
—
PA
05
—
1000013880058
—
PA
05
—
1000013880059
—
PA
05
—
1000013880061
—
PA
05
—
1000013880063
—
PA
01
—
1576764PT
HIGHMARK BLUE SHIELD
PA
01
—
1576770ST
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/01/2007
Last updated
06/16/2008
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