| NPI | 1295377083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT CHARLES CARROLL Founder And CEO 505-710-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry | |
| 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities | |
| 2084P0301X Psychiatry & Neurology Brain Injury Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| Enumeration Date | 2019-10-13 |
| Last Update Date | 2020-01-01 |