| NPI | 1821515818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK MICHAEL KELLY President 424-269-0086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2024-01-18 |