| NPI | 1174292221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANCHAJANYA PAUL Owner 678-250-8883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2021-09-11 |
| Last Update Date | 2023-10-05 |