| Organization Name: | WYOMING VALLEY ALCOHOL & DRUG SERVICES, INC |
| NPI Number: | 1558532671 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JASON HARLEN (CEO) |
| Mailing Address: | 49 South Main St. Pittston |
| State: | PA US |
| Postal Code: | 18640 |
| Phone Number: | 5708208888 |
| Fax Number: | 5708208899 |
| NPI Enumeration Date: | 03/17/2008 |
| NPI Last Update Date: | 11/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 401216 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |