| NPI | 1508448663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELETTI Executive Director 570-332-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2023-10-12 |