| NPI | 1487060638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT IAN COHEN COO 800-388-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 201400) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2023-03-12 |