| NPI | 1205372059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL MARIE CLARK Owner 302-604-3906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: DE PC-0000366) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |