NPI | 1962102830 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDSEY LAWRENCE Owner 716-359-0045 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-03-08 |
Last Update Date | 2023-04-03 |