| NPI | 1851644348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ANN BRADLEY-DIVER Behavior Specialist Mt 610-357-1817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-10-21 |
| Last Update Date | 2012-10-21 |