| NPI | 1992995104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN R DITTMAN Administrator 814-226-6252 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-07-26 |