| NPI | 1154738417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY JOSEPH GILGALLON Project Coordinator/Ed 570-878-8213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: PA 357040) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2014-07-18 |