Organization
LOURDESMONT BEHAVIORAL HEALTH SERVICES
Active
Other names
Good Shepherd Youth and Family Services of Nepa
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAL SANTOLI M.S. (COO)
(570) 348-6100
Entity
Organization
Contact information
Practice address
1327 WYOMING AVE, SCRANTON, PA 18509-2861
(570) 702-8360
(570) 702-8623
Mailing address
1327 WYOMING AVE, SCRANTON, PA 18509-2861
(570) 702-8360
(570) 702-8623
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
000204170
PA
251S00000X
Community/Behavioral Health Agency
Primary
000204170
PA
261Q00000X
Clinic/Center
000204170
PA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
000204170
PA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
000204170
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007283070011
—
PA
Enumeration date
04/17/2007
Last updated
06/06/2014
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