| NPI | 1255823258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN MICHAEL LEY Owner 619-268-1274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 207P00000X Emergency Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2026-04-23 |