| NPI | 1316086655 |
|---|---|
| Former Legal Business Name | MINSEC ERIE OUTPATIENT |
| Entity Type | Organization |
| Authorized Contact | BERTEE THOMAS Director Of Re Entry Operations 215-744-9601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PA 807220) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2016-09-07 |