| NPI | 1144375767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HENDRICKS Chief Executive Officer 814-940-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC MLH-011-272) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2024-04-10 |