| NPI | 1629698766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA VITULLO Director Of Payer Operations 866-959-2008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2024-10-18 |