| NPI | 1003521006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODENE JENSEN President 407-638-8903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-06-11 |