| NPI | 1083387302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE AMAH Director 346-445-3387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2021-08-02 |