| NPI | 1104511039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAMLESH J SISODIYA President 737-276-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2024-12-16 |