| NPI | 1750895413 |
|---|---|
| Other Name | GAVIN QUINCY |
| Entity Type | Organization |
| Authorized Contact | JOHN MCGAHAN President/CEO 857-496-7341 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2017-11-16 |