LAKE SCRANTON RENEW CENTER NPI 1770285769

NPI Information

  • NPI: 1770285769
  • Provider Name: LAKE SCRANTON RENEW CENTER
  • Classification: Internal Medicine - 207RA0401X
  • Specialization: Addiction Medicine
  • Entity Type: Organization
  • Address: 1141 MOOSIC ST STE 3
    SCRANTON, PA
    ZIP 18505
  • Phone: (570) 800-5926

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NPI Details

LAKE SCRANTON RENEW CENTER is an addiction medicine internal medicine in Scranton, PA. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. LAKE SCRANTON RENEW CENTER NPI is 1770285769. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1141 MOOSIC ST STE 3
SCRANTON, PA
ZIP 18505-105
Phone: (570) 800-5926
Fax: (570) 955-5556

The provider's authorized official is Brianne Balchune .
The authorized official title is Office Manager and has the following contact phone number (570) 800-5926.

The enumeration date for this NPI number is 3/21/2023 and was last updated on 4/19/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RA0401XInternal MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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