| NPI | 1356940373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALIAH MOODY Owner 215-791-8430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2024-10-25 |