| NPI | 1174027189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE CADDICK Owner/Member 570-877-2536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: FL NA) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2020-04-03 |