| NPI | 1134669963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENCIA M GOMEZ President 754-333-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME121955) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2024-06-06 |