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General NPI Number Information
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NPI Number | 1316213754
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Entity Type | Organization
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Legal Business Name | REDWOOD RECOVERY CENTERS, LLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 614 WYOMING AVE
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City | SCRANTON
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State | PA
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Zip | 18509-3027
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Country | US
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Telephone | 570-392-9666
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Fax |
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Provider Business Mailing Address
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Address Line | 13 NORTH ST
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City | PLAINS
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State | PA
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Zip | 18705-3341
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Country | US
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Telephone | 570-878-7887
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. LAWRENCE S RINISH
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Credential | MBA, CAC
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Telephone | 570-878-7887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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