| NPI | 1831792795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY SHROYER Owner 570-701-7364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2020-11-20 |