Healthcare Provider Details

I. General information

NPI: 1326105552
Provider Name (Legal Business Name): ENCORE THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 4 BOX 646
WEST PITTSTON PA
18643-9321
US

IV. Provider business mailing address

RR 4 BOX 646
WEST PITTSTON PA
18643-9321
US

V. Phone/Fax

Practice location:
  • Phone: 570-388-4094
  • Fax: 570-388-2104
Mailing address:
  • Phone: 570-388-4094
  • Fax: 570-388-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JANINE H DYMOND
Title or Position: CEO
Credential: OTRL
Phone: 570-388-4094