| NPI | 1962965145 |
|---|---|
| Doing Business As | PROVIDENCE TREATMENT |
| Other Name | PROVIDENCE TREATMENT |
| Entity Type | Organization |
| Authorized Contact | WILLIAM HERAN CEO 484-445-4145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2021-05-07 |