Organization
LUZERNE WYOMING COUNTY MH CENTER #1
Active
Other names
Choices
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH H KNECHT (CEO)
(570) 552-3900
Entity
Organization
Contact information
Practice address
R 307 LAIRD STREET, WILKES-BARRE, PA 18702
(570) 408-9320
(570) 408-9324
Mailing address
562 WYOMING AVE, KINGSTON, PA 18704-3721
(570) 552-3900
(570) 552-3907
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002080-0051
—
PA
Enumeration date
04/02/2007
Last updated
08/22/2020
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