| NPI | 1396880621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA ELMER Credentialing Specialist 717-755-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: PA 320980) |
| Additional Taxonomies | 253J00000X Foster Care Agency (Licence: PA 327620) |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: PA 303660) | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PA 320980) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: PA 316860) | |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: PA 677058) | |
| 252Y00000X Early Intervention Provider Agency (Licence: PA 320980) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2018-07-18 |