Provider Demographics
NPI:1326105552
Name:ENCORE THERAPY SERVICES INC
Entity Type:Organization
Organization Name:ENCORE THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:H
Authorized Official - Last Name:DYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:570-388-4094
Mailing Address - Street 1:RR 4 BOX 646
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-9321
Mailing Address - Country:US
Mailing Address - Phone:570-388-4094
Mailing Address - Fax:570-388-2104
Practice Address - Street 1:RR 4 BOX 646
Practice Address - Street 2:
Practice Address - City:WEST PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18643-9321
Practice Address - Country:US
Practice Address - Phone:570-388-4094
Practice Address - Fax:570-388-2104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000000770003Medicaid