| NPI | 1609703677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MALZ Psychiatric Nurse Practitioner 551-804-1618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2026-05-05 |
| Last Update Date | 2026-05-05 |