| NPI | 1124450069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON E HENDRICKS CEO 814-940-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: PA 457040) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PA 457040) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2024-04-10 |