| NPI | 1538725940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID NIKNAFS Owner 800-829-4933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2022-03-29 |