| NPI | 1811504806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOK REICHENBACH Business Office Manager 570-524-9986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |