NPI | 1063102226 |
---|---|
Doing Business As | EMBARK VIRTUAL AT MISSOURI |
Entity Type | Organization |
Authorized Contact | SHARNELL SPENCER Credentialing Manager 661-239-6923 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-05-11 |
Last Update Date | 2025-05-15 |