| NPI | 1639839962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIERA M ANDERSON Director 215-847-7053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2021-12-28 |