| NPI | 1033649298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JOSEPH BRODERICK-CANTWELL Owner 251-517-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 28950) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2018-01-10 |