Healthcare Provider Details

I. General information

NPI: 1285793448
Provider Name (Legal Business Name): THE ADVOCACY ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 JEFFERSON AVE
SCRANTON PA
18510-1032
US

IV. Provider business mailing address

846 JEFFERSON AVE POST OFFICE BOX 1368
SCRANTON PA
18510-1032
US

V. Phone/Fax

Practice location:
  • Phone: 570-342-7762
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

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

# 1
Identifier1000165500002
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: ALEX J HAZZOURI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 570-558-5580