| NPI | 1386903482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI SARVIS Lcsw, Pa 954-426-0410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: FL sw0002627) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2019-06-06 |