=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013326321
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PA TREATMENT & HEALING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2014
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 237 E BROWN ST
-----------------------------------------------------
City | EAST STROUDSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18301-3005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-223-5036
-----------------------------------------------------
Fax | 570-223-5037
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 28 N FRONT ST
-----------------------------------------------------
City | MILTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17847-1229
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-246-5866
-----------------------------------------------------
Fax | 570-246-5888
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF FINANCE
-----------------------------------------------------
Name | HEATHER HAEFNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 570-246-5866
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------