| NPI | 1205389749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CROALL President 754-300-4518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2016-08-02 |