| NPI | 1285794081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH T ABJELINA Owner Provider 424-400-7748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA A64789) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2016-11-04 |