| NPI | 1164947826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE CHAYKA President 267-975-0089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 163W00000X Registered Nurse | |
| 251S00000X | |
| 251X00000X | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2022-07-21 |