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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