| NPI | 1518413764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA J DOOLEY CFO 800-370-3651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| 1041C0700X Social Worker Clinical | |
| 363L00000X Nurse Practitioner | |
| 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health | |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2017-01-05 |