| NPI | 1962889683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LYNN HOLTZMAN Owner 570-692-2270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: PA 187042) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |