Healthcare Provider Details

I. General information

NPI: 1962547133
Provider Name (Legal Business Name): THE ARC OF LACKAWANNA COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 MEADOW AVE
SCRANTON PA
18505-2168
US

IV. Provider business mailing address

115 MEADOW AVE
SCRANTON PA
18505-2168
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-4010
  • Fax: 570-346-8436
Mailing address:
  • Phone: 570-346-4010
  • Fax: 570-346-8436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number220430
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number219600
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. DONALD W BRODERICK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 570-346-4010