Organization
LOURDESMONT BEHAVIORAL HEALTH SERVICES
Active
Organization
LOURDESMONT BEHAVIORAL HEALTH SERVICES
Active
Other names
Lourdesmont Good Shepherd
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAL SANTOLI M.S. (COO)
(570) 348-6100
Entity
Organization
Contact information
Practice address
537 VENARD RD, CLARKS SUMMIT, PA 18411-1249
(570) 587-4741
(570) 586-0030
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
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007283070009
—
PA
Enumeration date
04/17/2007
Last updated
05/08/2014
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