| NPI | 1427627710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS MEYER Manager 866-456-1813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2021-06-21 |