| NPI | 1104424829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARSHALL Director Of Billing & Collections 570-203-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2023-08-17 |