| NPI | 1083320899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L COOPER CEO/Founder 848-220-6659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 405300000X Prevention Professional | |
| 163WP0808X Registered Nurse, Psych/Mental Health | |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-12-21 |