Provider Demographics
NPI:1619420296
Name:SOLID BEDROCK LLC
Entity Type:Organization
Organization Name:SOLID BEDROCK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:570-240-1660
Mailing Address - Street 1:62 DALLAS VILLAGE SHOPPING CTR
Mailing Address - Street 2:SUITE 313
Mailing Address - City:DALLAS
Mailing Address - State:PA
Mailing Address - Zip Code:18612-1231
Mailing Address - Country:US
Mailing Address - Phone:570-240-1660
Mailing Address - Fax:561-207-7765
Practice Address - Street 1:367 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-6314
Practice Address - Country:US
Practice Address - Phone:570-240-1660
Practice Address - Fax:561-207-7765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility