| NPI | 1053779561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE TOLERICO Billing Manager 570-963-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: PA 23864001) |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2016-01-29 |