| NPI | 1356050108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAIJAH JAYE DAVIS Community Recovery Specialist 570-580-7551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-21 |