| NPI | 1548051378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RICHARD ENSLIN COO 570-903-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-05-13 |
| Last Update Date | 2025-05-28 |