| NPI | 1265656623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN J HARTL Executive Director 267-893-5285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2008-05-29 |