| NPI | 1003361635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVINDRA SHAH Chief Operating Officer 267-210-8357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX Q4829) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX AP129429) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2021-05-05 |