| NPI | 1205341286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JOHN MATSKO President 570-354-2127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA BH001844) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2019-12-15 |