Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
Other names
Carbondale Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA LACEY (EXECUTIVE DIRECTOR)
(570) 253-8451
Entity
Organization
Contact information
Practice address
150 BROOKLYN ST, CARBONDALE, PA 18407-2274
(570) 282-2031
(570) 282-2534
Mailing address
601 PARK ST, HONESDALE, PA 18431-1445
(570) 251-6641
(570) 253-8228
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/18/2012
Last updated
04/11/2023
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