| NPI | 1679141501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SMITH Executive Director 484-401-0087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2024-04-16 |