| NPI | 1114646650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARSHALL Director, Billing & Collections 570-203-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-08-26 |
| Last Update Date | 2024-03-27 |