| Colonial Intermediate Unit #20 | |
|
780 Memorial Blvd Tobyhanna PA 18466-7788 | |
| (610) 515-6439 | |
| (484) 291-4135 |
| Full Name | Colonial Intermediate Unit #20 |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 780 Memorial Blvd, Tobyhanna, Pennsylvania |
| Authorized Official Name and Position | Jen Kosiba (ASST MGMT FOR BILLING) |
| Authorized Official Contact | 6105156439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Colonial Intermediate Unit #20 6 Danforth Dr Easton PA 18045-7820 Ph: (610) 515-6439 | Colonial Intermediate Unit #20 780 Memorial Blvd Tobyhanna PA 18466-7788 Ph: (610) 515-6439 |
| NPI Number | 1114814019 |
|---|---|
| Provider Enumeration Date | 06/23/2025 |
| Last Update Date | 06/23/2025 |
| Certification Date | 06/23/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114814019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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