| NPI | 1952888265 |
|---|---|
| Former Legal Business Name | ELITE PSYCHIATRY PC |
| Entity Type | Organization |
| Authorized Contact | RAVEN ELLIOTT MODISETTE C.E.O 817-695-5035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: TX M9770) |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2018-07-20 |
| Last Update Date | 2020-05-16 |