NPI | 1629588496 |
---|---|
Entity Type | Organization |
Authorized Contact | ALICIA ROBERSON President 107-458-8895 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
Enumeration Date | 2017-10-06 |
Last Update Date | 2025-03-28 |