| NPI | 1023559846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN CIAMPI CEO 844-884-4474 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |