| NPI | 1871275222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA PERSAUD Sr. Contracting Mgr 484-501-4462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2023-08-04 |
| Last Update Date | 2023-08-04 |