NPIMap

Organization Active NPI

Wilkes Barre Behavioral Hospital Company LLC

  • Federally Qualified Health Center (FQHC)
  • Kingston, PA
National Provider Identifier
1073842936
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC
Practice address
562 Wyoming Ave
Kingston, PA 18704-3721
Phone
(570) 552-3700
Fax
(570) 552-3733
NPI assigned
Dec 23, 2009
Last updated
Dec 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Laurie Holtsford
Title
Authorized Official
Phone
(615) 465-7466

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Registered Nurse 163W00000X NU

Addresses

Primary practice location

562 Wyoming Ave
Kingston, PA 18704-3721

Mailing address

562 Wyoming Ave
Kingston, PA 18704-3721
Phone (570) 552-3700

National Provider Directory

National Provider Directory
Tax ID family
Wilkes-Barre Behav Hosp24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1073842936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "562 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043721",
            "telephone_number": "570-552-3700",
            "fax_number": "570-552-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "562 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043721",
            "telephone_number": "570-552-3700",
            "fax_number": "570-552-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-23",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "HOLTSFORD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-465-7466"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.