| NPI | 1861645350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAZARO PEPEN First Officer 610-374-4576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: PA MD062674L) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2019-06-05 |