| NPI | 1013398130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON M LIEB Executive Officer 814-883-9949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-07-20 |