| NPI | 1588289417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH F WOOD Assistant Secretary 424-290-3341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2020-06-17 |