| NPI | 1972165231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA TASHA AL-JARBOUA CEO 833-779-2633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2019-07-07 |
| Last Update Date | 2019-07-07 |