| NPI | 1891152062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA BOURGEOIS Health Information Systems Director 215-728-4610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: PA 125170) |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2016-01-19 |