| NPI | 1962553800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANCE HUDSON Executive Director 215-850-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: PA 807245) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: PA 807245) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2016-02-24 |