Organization
GOODWILL INDUSTRIES OF NE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD T LANGAN (PRESIDENT CEO)
(570) 343-1166
Entity
Organization
Contact information
Practice address
243 S WASHINGTON ST, WILKES BARRE, PA 18701-2802
(570) 706-9586
(570) 706-9587
Mailing address
925 PROSPECT AVE, SCRANTON, PA 18505-1858
(570) 343-1166
(570) 343-6765
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
205250
PA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
226671
PA
Other
Enumeration date
03/12/2007
Last updated
09/24/2015
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