| NPI | 1417177205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ED ABDO Executive Director 570-735-7590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: PA 1007615710008) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: PA 1007615710008) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |