| NPI | 1942086368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY DIAGO CEO 725-910-3725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2023-09-01 |
| Last Update Date | 2023-09-01 |