Provider Demographics
NPI:1053150425
Name:BEYOND ADDICTION AT WELLWOOD DRIVE
Entity type:Organization
Organization Name:BEYOND ADDICTION AT WELLWOOD DRIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SWEPSTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-406-6662
Mailing Address - Street 1:219 WELLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-2019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:219 WELLWOOD DR
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-2019
Practice Address - Country:US
Practice Address - Phone:570-406-6662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit