| NPI | 1508694555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GREESPAN VP Payor Relations 888-228-2384 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |