| Organization Name: | FSLJC, LLC. |
| NPI Number: | 1346266087 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN J COLLINI (ADMINISTRATOR) |
| Mailing Address: | 113 N Memorial Hwy Shavertown |
| State: | PA US |
| Postal Code: | 187081426 |
| Phone Number: | 5706746525 |
| Fax Number: | 5706746520 |
| NPI Enumeration Date: | 07/14/2006 |
| NPI Last Update Date: | 10/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |