Restorative Roots Wilkes-Barre, LLC
Community/Behavioral Health in Edwardsville, PA. Organization (NPI-2).
NPI number1124987482
StatusActive
Last updated in NPPESFeb 5, 2026
Details
- NPI
- 1124987482
- Entity type
- Organization (NPI-2)
- Legal business name
- Restorative Roots Wilkes-Barre, LLC
- Organization subpart
- No
- Enumeration date
- Jan 21, 2026
- Certification date
- Feb 5, 2026
- Last updated
- Feb 5, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
| 251B00000X | Case Management | – | – |
Practice location
786 Main StEdwardsville, PA 18704-1762
Phone 570-338-5911
Mailing address
453 Arena Hub Plz # 1053Wilkes Barre, PA 18702-6839
Phone 570-338-5911
Other practice locations
788 Main St
Edwardsville, PA 18704-1762
Edwardsville, PA 18704-1762
Phone 570-338-5911
114 Orchard St
Plymouth, PA 18651-1628
Plymouth, PA 18651-1628
Phone 570-338-5911
334 N Main St
Wilkes Barre, PA 18702-4410
Wilkes Barre, PA 18702-4410
Phone 570-338-5911
Authorized official
Joseph Aiello
Managing Partner
5703385911
Is something wrong?
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