| NPI | 1902594005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT FEARS President And Chief Medical Officer 424-293-0031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2023-04-26 |
| Last Update Date | 2023-04-26 |