| NPI | 1518522242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JACKSON KOEHLER Partner 814-397-7480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2022-09-26 |