| NPI | 1912421702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KADANKAVIL JOSEPH Owner/Proprietor 267-244-9537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: PA CW016126) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-08-02 |