| NPI | 1366242802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIELA PADRO Member 645-224-2402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-07-30 |