| NPI | 1700382066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE K CAMPLING Credentialing Insurance Specialist 610-931-1217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-08-14 |