| NPI | 1477012813 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WILLIAM LEONARD President 855-711-4867  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry | 
| Additional Taxonomies | 261Q00000X Clinic/Center | 
| Enumeration Date | 2019-03-15 | 
| Last Update Date | 2025-04-08 |