| NPI | 1003769993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILENA MASK CEO/Owner 269-352-3753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2026-02-19 |
| Last Update Date | 2026-02-19 |