| NPI | 1861033151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ANTHONY DAVITT Accounts Receivable COO Rdinator 570-702-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2019-10-08 |
| Last Update Date | 2019-10-08 |