| NPI | 1558341867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE L KISSICK Medical Office Administrator 724-657-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 400930) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA 400930) |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2013-05-14 |