| NPI | 1619533098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE JOHNSON Clinical Director 215-802-3533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-05-11 |
| Last Update Date | 2023-05-25 |