| NPI | 1295136661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENEKA RAINS Vice President/ COO 888-730-2437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |