| NPI | 1538807011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE GILLIAM VP Of Operations 833-494-6724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology Behavioral Neurology & Neuropsychiatry |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health | |
| 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult | |
| 364SP0810X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Family | |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2025-04-21 |