Sanctuary at Lake Ariel LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

SANCTUARY AT LAKE ARIEL LLC

Practice address

50 Industrial Park Rd
Lake Ariel, PA 18436-5606

Phone

(570) 258-8099

NPI assigned

Mar 8, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Steve Imburgio

Title

Ceo

Phone

(347) 213-1473

Specialties & licenses 1

Addresses

Other names 1

• Lake Ariel Recovery Center Doing business as

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

{
    "created_epoch": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1699277376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 KINGS HWY N STE 100",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 INDUSTRIAL PARK RD",
            "city": "LAKE ARIEL",
            "state": "PA",
            "postal_code": "184365606",
            "telephone_number": "570-258-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANCTUARY AT LAKE ARIEL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "IMBURGIO",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-213-1473",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Ariel Recovery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rite Aid of Pennsylvania LLC
• Dominick Rizzo
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• Kelsey Russo
• Jennifer Marie Sabatelle, RN
• Katherine Rosalie Schloesser, DMD
• Sabrina Elise Shander, CRNP
• Jenna Smith, PA-C
• April Ann Spencer, COTA/L
• Sprout Pediatric Dental

• Substance Abuse Rehabilitation Facility in Lake Ariel, PA
• Providers in Lake Ariel, PA by specialty
• Substance Abuse Rehabilitation Facility in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2018; 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.