| NPI | 1043647084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HENDRICKS Chief Executive Officer 814-940-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: none housing only) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2013-10-05 |
| Last Update Date | 2024-04-10 |