| NPI | 1538145453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM SOHOSKY COO 570-682-5215 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X (Licence: PA 206880) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261Q00000X | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2020-08-20 |