| NPI | 1972192953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN JAMES CEO 888-209-4955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2021-01-14 |