| NPI | 1003030644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSANNE M MIRANDO Medical Biller 717-206-1368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 01756972) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2015-10-20 |