| NPI | 1871891168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE VISNICK Project Director 866-472-9466 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA 433860) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2014-05-08 |