| NPI | 1053156331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOTAYO GBENGAOJO Owner/Authorised Official 817-523-8812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2025-09-04 |