NPIMap

Organization Active NPI

Luzerne/Wyoming County MH Center #1

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wilkes Barre, PA
National Provider Identifier
1538317466
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
219250 Issued in PA
Legal business name
LUZERNE/WYOMING COUNTY MH CENTER #1
Practice address
110 S Pennsylvania Ave
Wilkes Barre, PA 18701-3301
Phone
(570) 552-6000
NPI assigned
Sep 4, 2008
Last updated
Sep 4, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
LUZERNE/WYOMING COUNTY MH CENTER #1As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Authorized official

Name
Frank Piazza
Title
Contoller/Mis Director
Phone
(570) 552-3625

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 219250 PA Primary

Addresses

Primary practice location

110 S Pennsylvania Ave
Wilkes Barre, PA 18701-3301

Mailing address

562 Wyoming Ave
Kingston, PA 18704-3721
Phone (570) 552-3625

Other identifiers 1

IdentifierTypeStateIssuer
100002080MedicaidPA

Other names 1

  • PSYCH REHAB Other name

National Provider Directory

National Provider Directory
Tax ID family
Luzerne Wyoming County36 organizations share this tax ID, including this one
Part of
Luzerne Wyoming County

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1538317466",
    "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": "570-552-3625",
            "fax_number": "570-552-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013301",
            "telephone_number": "570-552-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUZERNE/WYOMING COUNTY MH CENTER #1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUZERNE/WYOMING COUNTY MH CENTER #1",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "PIAZZA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CONTOLLER/MIS DIRECTOR",
        "authorized_official_telephone_number": "570-552-3625"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "219250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002080",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PSYCH REHAB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.