| NPI | 1538991146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER PUSHKA Owner 954-579-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0805X |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2024-08-14 |
| Last Update Date | 2025-08-22 |