| NPI | 1922458108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS BARDOUTSOS Managing Partner 570-239-8607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2024-08-01 |