NPIMap

Organization Active NPI

Wilkes Barre Behavioral Hospital Company LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Kingston, PA
National Provider Identifier
1992931893
Registry record updated Jun 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
407030 Issued in PA
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
Jun 5, 2009
Organization subpart
Yes
Parent organization
WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2009

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

Authorized official

Name
Laurie Holtsford
Title
Director
Phone
(615) 465-7466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 407030 PA Primary

Addresses

Primary practice location

562 Wyoming Ave
Kingston, PA 18704-3721

Mailing address

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

Other names 1

  • Choices Program of Wyoming Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wilkes Barre Behavioral Hospital Company LLC24 organizations share this tax ID, including this one
Part of
Wilkes Barre Behavioral Hospital Company LLC

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": "1244160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244160000000",
    "number": "1992931893",
    "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": "YES",
        "parent_organization_legal_business_name": "WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC",
        "enumeration_date": "2009-06-05",
        "last_updated": "2009-06-05",
        "status": "A",
        "authorized_official_last_name": "HOLTSFORD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-465-7466"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "PA",
            "license": "407030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choices Program of Wyoming Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 5, 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.