| NPI | 1770347577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNELLE SUPER Owner 814-881-5299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-07-11 |