Luzerne Wyoming Counties Mental Health Mental Retardation Program
NPI #1154455061 in Wilkes Barre, Pennsylvania
Provider Information
- NPI Number
- 1154455061
- Entity Type
- Organization
- Organization Name
- Luzerne Wyoming Counties Mental Health Mental Retardation Program
- Primary Specialty
- Case Manager/Care Coordinator
- Enumeration Date
- Mar 15, 2007
- Last Updated
- Jan 4, 2016
Practice Location
- Address
- 111 N PENNSYLVANIA AVE
- Address 2
- SUITE 200
- City
- Wilkes Barre
- State
- Pennsylvania
- ZIP Code
- 18701-3511
- Phone
- (570) 831-7277
Authorized Official
- Name
- MRS. ANTOINETTE CISOWSKI
- Title
- MH MR ADMINISTRATOR
- Phone
- (570) 825-9441
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Manager/Care Coordinator |
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