WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC (NPI# 1093070583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093070583 |
| Entity Type | Organization |
| Organization Name | WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC |
| Other Organization Name | COMMUNITY RESIDENTIAL REHAB #1 |
| Practice Address |
76 S Dawes Ave Kingston PA 18704-5710 |
| Mailing Address |
562 Wyoming Ave Kingston PA 18704-3721 |
| Practice Telephone | 5707180833 |
| Mailing Telephone | 5705523865 |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2018-04-12 |
| Authorized Official Name | PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILKES BARRE BEHAVIORAL HOSPITAL COMPANY LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 221020 | PA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Community Residential Rehab #1 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649535139 | Wilkes Barre Behavioral Hospital Company LLC | Community Based Residential Treatment Facility, Mental Illness | 3504 Bear Creek Blvd, Bear Creek Township, PA 18702-9760 | 2012-07-10 |
| 1073842936 | Wilkes Barre Behavioral Hospital Company LLC | Registered Nurse | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-12-23 |
| 1982835484 | Wilkes Barre Behavioral Hospital Company LLC | Case Management | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2009-07-31 |
| 1669608477 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 99 Bridge St, Tunkhannock, PA 18657-1303 | 2009-06-08 |
| 1114153921 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-08 |
| 1477789287 | Wilkes Barre Behavioral Hospital Company LLC | Case Management | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-08 |
| 1386870194 | Wilkes Barre Behavioral Hospital Company LLC | Case Management | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2009-06-08 |
| 1376779181 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2009-06-08 |
| 1568698371 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 110 S Pennsylvania Ave, Wilkes Barre, PA 18701-3301 | 2009-06-08 |
| 1992931893 | Wilkes Barre Behavioral Hospital Company LLC | Clinic/Center | 562 Wyoming Ave, Kingston, PA 18704-3721 | 2009-06-05 |
| Street Address |
76 S DAWES AVE |
| City | KINGSTON |
| State | PA |
| Zip Code | 18704-5710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124635271 | Allied Health Care Services | Community/Behavioral Health | 76 S Dawes Ave, Kingston, PA 18704-5710 | 2020-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013557552 | Millmark Health Inc. | Psychiatry & Neurology | 511 Pierce Street, Kingston, PA 18704 | 2020-01-13 |
| 1427550334 | Michael Anthony Waltich | Military Health Care Provider | 82 Cooper Street, Pringle, PA 18704 | 2018-03-06 |
| 1376088435 | Jae LLC | Massage Therapist | 512 Northhampton Street, Edwardsville, PA 18704 | 2016-12-28 |
| 1306278288 | Mohammad Khaled Tashkandi | Internal Medicine | 490 Northampton St Ste 1, Edwardsville, PA 18704 | 2013-08-02 |
| 1396180014 | Sammie Craven IIi | Pharmacist | 96 1st Avenue, Kingston, PA 18704 | 2013-05-08 |
| 1447693114 | Catherine Mary Harding | Nurse Practitioner | 141 South Maple Ave, Kingston, PA 18704 | 2013-04-12 |
| 1861781403 | Jennifer Ann Richards | Pharmacist | 22 West Side Mall, Edwardsville, PA 18704 | 2011-04-05 |
| 1558512772 | Jolon Theresa Sherin | Speech-Language Pathologist | 1825 Sans Souci Highway, Hanover, PA 18704 | 2008-10-07 |
| 1932361102 | Kari Ann Pietralczyk | Audiologist | 190 Welles Street, Forty-fort, PA 18704 | 2008-06-30 |
| 1467584151 | John Christopher Storti | Chiropractor | 180 United Penn Plaza, Kingston, PA 18704 | 2007-03-09 |
| Find all providers in zip 18704 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508985466 | Institute for Human Resources and Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 250 Pierce St, Suite 301, Kingston, PA 18704-5149 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383628 | New Visions of South Central Pa, Inc. | Community Based Residential Treatment Facility, Mental Illness | 138 E King St, Shippensburg, PA 17257-1329 | 2020-10-13 |
| 1174012868 | Andre Molando West | Community Based Residential Treatment Facility, Mental Illness | 444 Dalton Ave, Rochester, PA 15074-2402 | 2018-05-08 |
| 1013410224 | Aishah Holman | Community Based Residential Treatment Facility, Mental Illness | 221 Jacoby St, Norristown, PA 19401-4040 | 2018-03-14 |
| 1154858827 | Thoughtful Choice | Community Based Residential Treatment Facility, Mental Illness | 122 Faybern Ct, Verona, PA 15147-1507 | 2017-05-12 |
| 1154857365 | Housing and Education Resource Program Inc | Community Based Residential Treatment Facility, Mental Illness | 563 Stokes Ave, Braddock, PA 15104-2267 | 2017-05-08 |
| 1457892283 | Evangelical Alumni Inc. | Community Based Residential Treatment Facility, Mental Illness | 3232 N 33rd St, 3232 N 33rd St, Philadelphia, PA 19129-1202 | 2017-03-13 |
| 1871033118 | Shared Values | Community Based Residential Treatment Facility, Mental Illness | 17 Larkspur Ln, Collegeville, PA 19426-3931 | 2017-03-06 |
| 1932645108 | Elwyn | Community Based Residential Treatment Facility, Mental Illness | 5218 Germantown Ave, Philadelphia, PA 19144-2347 | 2017-01-12 |
| 1639536949 | Path (people Acting To Help) | Community Based Residential Treatment Facility, Mental Illness | 8429 Castor Ave, Philadelphia, PA 19152-1903 | 2016-01-19 |
| 1821453150 | Community Outreach Program | Community Based Residential Treatment Facility, Mental Illness | 1311 N 52nd St, Philadelphia, PA 19131-4412 | 2015-12-31 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.