| NPI | 1891174132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTON FISHER CEO 725-333-2411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2025-03-13 |