| NPI | 1043884992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KAY JENKINS Owner/ Nurse Practitioner 731-435-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2021-07-25 |