| NPI | 1013537141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE GENEN Owner 833-427-3566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103T00000X Psychologist | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2020-04-18 |