| NPI | 1104636232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESTER SUGGS Member 484-544-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-01-10 |