| NPI | 1497579825 |
|---|---|
| Other Name | MEDICAL DIRECTOR |
| Entity Type | Organization |
| Authorized Contact | RONNIE ALLEN POLLARD Owner 251-391-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2024-11-12 |
| Last Update Date | 2025-05-09 |