| NPI | 1568559714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY I BALOGUN Chairman/CEO 267-993-0256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: PA 101200) |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2025-07-09 |