Organization
DIVERSIFIED TREATMENT ALTERNATIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY J KELLEHER MA MED (ADMINISTRATOR)
(570) 524-9986
Entity
Organization
Contact information
Practice address
148 FAIRFIELD ROAD, LEWISBURG, PA 17837
(570) 524-9986
(570) 524-9973
Mailing address
148 FAIRFIELD ROAD, LEWISBURG, PA 17837
(570) 524-9986
(570) 524-9973
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
301960
PA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
348770
PA
385H00000X
Respite Care
Primary
308000
PA
Other
Enumeration date
05/17/2006
Last updated
09/11/2025
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