NPI | 1235465550 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON RYAN CANNON President 610-742-1679 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: VA 1417-05-001) |
Enumeration Date | 2009-10-21 |
Last Update Date | 2009-10-21 |