| Wilkes-barre Behavioral Hospital Company Llc | |
|
562 Wyoming Ave Kingston PA 18704-3721 | |
| (570) 552-3865 | |
| (570) 552-3875 |
| Full Name | Wilkes-barre Behavioral Hospital Company Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 562 Wyoming Ave, Kingston, Pennsylvania |
| Authorized Official Name and Position | Jennifer L Jackson (SENIOR DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilkes-barre Behavioral Hospital Company Llc 4000 Meridian Blvd Franklin TN 37067-6325 Ph: (615) 465-7000 | Wilkes-barre Behavioral Hospital Company Llc 562 Wyoming Ave Kingston PA 18704-3721 Ph: (570) 552-3865 |
| NPI Number | 1427292622 |
|---|---|
| Provider Enumeration Date | 05/01/2009 |
| Last Update Date | 01/25/2022 |
| Certification Date | 01/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427292622 | NPI | - | NPPES |
| 102288577-0005 | Medicaid | PA |
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