| NPI | 1407369408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH PETERSON CEO CFO 412-231-7866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: PA CER-00114910) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2017-11-22 |