Provider Demographics
NPI:1023551801
Name:LUZERNE COUNTY CHILDREN & YOUTH SERVICES
Entity Type:Organization
Organization Name:LUZERNE COUNTY CHILDREN & YOUTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-826-8710
Mailing Address - Street 1:111 NORTH PENNSYLVANIA AVENUE, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:WILKES-BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-3697
Mailing Address - Country:US
Mailing Address - Phone:570-826-8710
Mailing Address - Fax:570-826-8704
Practice Address - Street 1:111 NORTH PENNSYLVANIA AVENUE, SUITE 110
Practice Address - Street 2:
Practice Address - City:WILKES-BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-3697
Practice Address - Country:US
Practice Address - Phone:570-826-8710
Practice Address - Fax:570-826-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty