| NPI | 1285200584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOBERT BALLESTEROS POBLETE COO/Secretary 424-277-2899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2024-02-15 |