| NPI | 1720785900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERIDAN MAJOR-MOORE CEO 754-280-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology, Neurodevelopmental Disabilities |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2024-04-11 |