| NPI | 1689796286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON HENDRICKS CEO 814-940-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: PA 077023) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2024-04-10 |