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General NPI Number Information
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NPI Number | 1124987482
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Entity Type | Organization
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Legal Business Name | RESTORATIVE ROOTS WILKES-BARRE, LLC
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Dates
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Enumeration Date | 01/21/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 786 MAIN ST
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City | EDWARDSVILLE
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State | PA
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Zip | 18704-1762
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Country | US
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Telephone | 570-338-5911
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Fax |
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Provider Business Mailing Address
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Address Line | 453 ARENA HUB PLZ # 1053
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City | WILKES BARRE
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State | PA
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Zip | 18702-6839
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Country | US
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Telephone | 570-338-5911
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | JOSEPH AIELLO
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Credential |
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Telephone | 570-338-5911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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