| NPI | 1215558382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE BASHAM Billing Coordinator 717-393-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-04-30 |
| Last Update Date | 2021-09-15 |