| NPI | 1619947348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE LYNN DRAKE Executive Director 570-421-1960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: PA 131044) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: PA 451044) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2020-01-14 |