| NPI | 1992904130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TOLERICO Accounting Manager 570-282-1732 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |