| NPI | 1376177147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY GRANT SHALLENBERGER A VP Of Compliance 814-835-7621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2020-03-03 |