Organization
CORI'S PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE RANDALL GWILLIAM (EXECUTIVE DIRECTOR)
(570) 287-1237
Entity
Organization
Contact information
Practice address
78 MAIN ST, LUZERNE, PA 18709-1210
(570) 287-1237
Mailing address
78 MAIN ST, LUZERNE, PA 18709-1210
(570) 287-1237
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
212910
PA
Other
Enumeration date
03/07/2007
Last updated
08/22/2020
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