| NPI | 1972777522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARELEN GONZALEZ Executive Director 215-634-3259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2018-09-24 |