| NPI | 1932253465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE A COLLARES President Owner 937-435-0998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 35046922) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 5738) |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: OH 6234) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |