Healthcare Provider Details

I. General information

NPI: 1386422244
Provider Name (Legal Business Name): ADVOCACY ALLIANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 09/20/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 JEFFERSON AVE
SCRANTON PA
18510-1032
US

IV. Provider business mailing address

244 MAFFETT ST
PLAINS PA
18705-1007
US

V. Phone/Fax

Practice location:
  • Phone: 570-855-3587
  • Fax:
Mailing address:
  • Phone: 157-085-5358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: LAURA SHEDLOCK
Title or Position: NURSE EDUCATOR
Credential: RN
Phone: 570-855-3587