| NPI | 1639579147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LEIBOLD President 814-218-0551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW015648) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2014-09-03 |