| NPI | 1447982137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARSHALL Billing Manager 570-203-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2022-06-30 |