Organization
PA INNER VISION
Active
Organization
PA INNER VISION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL VICTOR ANDREWS (DIRECTOR)
(570) 476-1902
Entity
Organization
Contact information
Practice address
586 MAIN ST, SUITE 9, STROUDSBURG, PA 18360-2004
(570) 476-1902
(570) 476-4225
Mailing address
PO BOX 172, SHAWNEE ON DELAWARE, PA 18356-0172
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
457035
PA
Other
Enumeration date
02/03/2014
Last updated
02/20/2015
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