| NPI | 1679903363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA MARIE WATKINS Owner 570-766-9970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA PC006468) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2025-01-02 |