| NPI | 1245691096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN FARRELL Licensed Behavioral Specialist, Aba 267-709-9589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA BH003020) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2022-11-17 |