Organization
COLONIAL INTERMEDIATE UNIT 20
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEN KOSIBA (MEDICAL BILLER RESOLVE OUTPATIENT)
(610) 515-6439
Entity
Organization
Contact information
Practice address
1375 ROUTE 739, DINGMANS FERRY, PA 18328-3406
(610) 515-6439
Mailing address
6 DANFORTH DR, EASTON, PA 18045-7820
(610) 515-6439
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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