| Community Counseling Svcs Mrdd Transp | |
|
562 Wyoming Ave Kingston PA 18704-3721 | |
| (570) 552-3900 | |
| (570) 552-3907 |
| Full Name | Community Counseling Svcs Mrdd Transp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 562 Wyoming Ave, Kingston, Pennsylvania |
| Authorized Official Name and Position | Joseph H Knecht (CEO) |
| Authorized Official Contact | 5705523900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Counseling Svcs Mrdd Transp 562 Wyoming Ave Kingston PA 18704-3721 Ph: (570) 552-3900 | Community Counseling Svcs Mrdd Transp 562 Wyoming Ave Kingston PA 18704-3721 Ph: (570) 552-3900 |
| NPI Number | 1285803239 |
|---|---|
| Provider Enumeration Date | 02/25/2008 |
| Last Update Date | 02/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285803239 | NPI | - | NPPES |
| 1000020800060 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 222490 (Pennsylvania) | Primary |
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