| NPI | 1053987552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAMIDELE A AJAYI Owner 870-702-1465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2023-09-13 |