| NPI | 1841070794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALEB JOSEF MADISON Director Of Operations 610-333-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-09-28 |
| Last Update Date | 2024-06-20 |