| NPI | 1598236283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLENE MACMILLAN Co Owner 929-227-6577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2018-12-06 |
| Last Update Date | 2023-05-23 |