| NPI | 1891430757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROBERT GASTFRIEND Chief Medical Officer 855-539-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 175T00000X Peer Specialist |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2022-05-04 |
| Last Update Date | 2024-07-03 |