| NPI | 1336728724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ALAN MCCONNELL Program Manager 814-934-6513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2021-04-06 |