| NPI | 1588056212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYSA MONIQUE CHRISTINE JENKINS-HAYDEN Chief Clinical Officer 267-368-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007537) |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-04 |