| NPI | 1043030307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH-JANE ABRAHAM Program Manager 346-269-4045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-10-24 |