| NPI | 1538702964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M GLANDER CEO 855-437-6779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |