Organization
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Active
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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