| NPI | 1023822699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE ANGELA BROWN Owner 501-613-7863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 251S00000X | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QP2400X Clinic/Center, Prison Health | |
| 261QR1300X Clinic/Center, Rural Health | |
| 261QS1000X Clinic/Center, Student Health | |
| 332900000X Non-Pharmacy Dispensing Site | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| 347C00000X Private Vehicle | |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |