| NPI | 1215208301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HENDRICKS CEO 814-940-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PA 287051) |
| Additional Taxonomies | 261Q00000X (Licence: PA 287051) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2024-04-10 |