| NPI | 1023875648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA HOLLANDER Care Operations Manager 888-729-1971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-02-29 |