OrganizationActive
Luzerne Wyoming Counties Mental Health Mental Retardation Program
NPI 1629104682 · Case Management Agency · Wilkes Barre, PA
Provider details
- NPI number
- 1629104682
- Entity type
- Organization
- Primary specialty
- Case Management AgencyAgencies
- Organization subpart
- No
- Authorized official
- Antoinette Cisowski, Mh Mr Administrator(570) 825-9441
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
111 N Pennsylvania Ave
Suite 200
Wilkes Barre, PA 18701-3511
Phone: (570) 831-7277
Street-level locationGet directions
Mailing address
200 N River St
Wilkes Barre, PA 18711-1004
Registry dates
- Enumerated
- 2007-02-26
- Last updated
- 2015-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.