| NPI | 1225559552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SLACK COO 610-799-8525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: 218750) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |