| NPI | 1366853954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEVIEVE KING COO 484-731-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: VA 71406001) |
| Enumeration Date | 2014-05-16 |
| Last Update Date | 2022-09-14 |