| NPI | 1225961824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SEAN JOHNSON Medical Director 930-282-9432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2026-06-04 |
| Last Update Date | 2026-06-04 |