Organization
COLONIAL PARK INTENSIVE OUTPATIENT PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LAUS (OWNER)
(717) 991-4755
Entity
Organization
Contact information
Practice address
55 S PROGRESS AVE, HARRISBURG, PA 17109-4623
(717) 991-4755
(717) 724-5530
Mailing address
42 NW 3RD AVE, DELRAY BEACH, FL 33444-2622
(717) 991-4755
(717) 724-5530
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
10/23/2017
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