| NPI | 1164812269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ JOYA Manager 380-439-0085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: FL ME102618) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2022-07-21 |