| NPI | 1386372696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIAKSANDRA REGAN Medical Director 386-848-8751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2022-08-13 |
| Last Update Date | 2025-08-12 |