Organization
CHILDREN'S SERVICE CENTER OF WYOMING VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY SIMMONS (VP FINANCE)
(570) 825-6427
Entity
Organization
Contact information
Practice address
60 NEW HILL ST, WILKES-BARRE, PA 18702-4924
(570) 301-3300
Mailing address
335 S FRANKLIN ST, WILKES BARRE, PA 18702-3808
(570) 825-6425
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
1007280110024
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007280110024
—
PA
Enumeration date
04/12/2007
Last updated
08/22/2020
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