| NPI | 1598635294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT CLEMENTE Administrator 877-906-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2025-11-17 |