| NPI | 1639899636 |
|---|---|
| Doing Business As | EDNA AVE |
| Entity Type | Organization |
| Authorized Contact | MELISSA MARSHALL Director, Billing & Collections 570-203-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2024-03-27 |