| Organization Name: | LUZERNE WYOMING COUNTY MH CENTER #1 |
| NPI Number: | 1205957693 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH H KNECHT (CEO) |
| Mailing Address: | 99 Bridge St Tunkhannock |
| State: | PA US |
| Postal Code: | 186571303 |
| Phone Number: | 5708363118 |
| Fax Number: | 5708361117 |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |