| NPI | 1841469954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA FLEISCHUT Facility Director 570-628-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: PA PC000151) |
| Additional Taxonomies | 104100000X Social Worker (Licence: PA SW125918) |
| 291U00000X Clinical Medical Laboratory (Licence: PA PC000151) | |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2020-06-26 |