| NPI | 1992542658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISHA LUCAS Director 484-888-5174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-07-10 |
| Last Update Date | 2026-06-11 |