Provider Demographics
NPI:1639914211
Name:WYOMING VALLEY ALCOHOL AND DRUG SERVICES INC
Entity type:Organization
Organization Name:WYOMING VALLEY ALCOHOL AND DRUG SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:PIAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-820-8888
Mailing Address - Street 1:437 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18705-1613
Mailing Address - Country:US
Mailing Address - Phone:570-820-8888
Mailing Address - Fax:570-820-8899
Practice Address - Street 1:480 PIERCE ST STE 103
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5512
Practice Address - Country:US
Practice Address - Phone:570-820-8888
Practice Address - Fax:570-820-8888
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WYOMING VALLEY ALCOHOL AND DRUG SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)