| NPI | 1457820888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA ELIZABETH PELLY Administrator 276-608-4388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2020-02-04 |