Organization
PROVIVE WELLNESS SCRANTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYER WEBER (PARTNER)
(347) 374-1767
Entity
Organization
Contact information
Practice address
1123 CAPOUSE AVE, SCRANTON, PA 18509-2730
(347) 374-1767
Mailing address
15 PERLMAN DR STE 120, SPRING VALLEY, NY 10977-5281
(347) 374-1767
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/19/2026
Last updated
02/19/2026
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