| NPI | 1689182875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNE MILLER DIEMERT Owner 724-875-4946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA CW017704) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |