| NPI | 1750800439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BOES Owner 717-602-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2017-09-14 |