| NPI | 1306170295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHON MCMATH Chief Of Psychiatry 877-421-8263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: ME MC11962) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |