| NPI | 1316551682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARSHALL Director Of Billing & Collections 570-203-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2023-11-20 |