| NPI | 1003821497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS J RAIMONDO Manager 386-672-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084F0202X Psychiatry & Neurology, Forensic Psychiatry | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2012-10-11 |