| NPI | 1629556501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS JORDAN-MANZANO Owner 424-400-7748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A106140) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2018-08-01 |