| NPI | 1891772059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD L. KELLEY CEO 270-898-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2012-01-02 |