| NPI | 1497247894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DWAYNE HAY Member/Manager 855-227-1281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2020-04-08 |