| NPI | 1851077473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GRISCHKAN President 855-888-8250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-06-27 |