| NPI | 1063783678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAR BERGE Office Manager 814-535-8586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 168974) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2017-04-30 |