| NPI | 1033398078 |
|---|---|
| Other Name | THIRTY-NINE WEST VINE |
| Entity Type | Organization |
| Authorized Contact | HARVEY HAACK President 717-329-4178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 367079) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-11-23 |