| NPI | 1295397032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARINA MAHONEY VP Of Revenue Cycle Management 833-952-0829 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2025-06-05 |