| NPI | 1669722096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER DOMBROWSKI Credentialing Specialist 215-997-2000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2022-08-12 |