NPI | 1609090893 |
---|---|
Entity Type | Organization |
Authorized Contact | BARRY SIMMONS VP Finance 570-825-6427 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X (Licence: PA 1007280110001) |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: PA 1007280110001) |
Enumeration Date | 2007-04-12 |
Last Update Date | 2020-08-22 |