NPI | 1740457514 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON HENDRICKS CEO 814-940-0407 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: PA 677071) |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PA 677071) |
Enumeration Date | 2008-05-12 |
Last Update Date | 2024-04-10 |