| NPI | 1649815887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOK LEAH REICHENBACH Administrative Specialist 570-524-9986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2020-09-21 |