| NPI | 1336210699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICH JOHNSON Owner President 800-645-3267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PA 316910) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: PA 301480) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: PA 302410) | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children (Licence: PA 316970) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2020-08-22 |