| NPI | 1265872907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD JARGER Director Pi 484-454-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: PA 112610) |
| Additional Taxonomies | 251B00000X Case Management (Licence: PA 112610) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: PA 184890) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2016-01-14 |