| NPI | 1811506462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANDRANIE BUSJIT BHALAI Manager 754-799-4782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-07-31 |