Organization
HEALTH POCONOS, INC
Active
Other names
Riverside Rehabilitation Center II
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MAASSEN (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization
Contact information
Practice address
100 COMMUNITY DR, 105, TOBYHANNA, PA 18466-8985
(570) 839-9975
(570) 839-9274
Mailing address
100 COMMUNITY DR, 207, TOBYHANNA, PA 18466-8985
(570) 839-9975
(570) 839-9274
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
394532
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001467795
—
PA
01
—
0510083000
IBC
PA
01
—
2451453209
GEISINGER
PA
01
—
2Y4263
HEALTHNET
PA
01
—
50004997
CAPITAL BLUE CROSS
PA
01
—
543451
AETNA
PA
01
—
81386
THREE RIVERS
PA
01
—
E56832
AMERIHEALTH
PA
01
—
RI556832
BLUE SHIELD #
PA
Enumeration date
11/18/2005
Last updated
06/29/2012
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