| NPI | 1992137814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MCDONALD Sole Owner 424-400-7748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A112267) |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2014-09-11 |