| NPI | 1922841345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVIKUMAR PATEL Principal Owner 866-784-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine Addiction Medicine |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-07-31 |