NPI | 1104694389 |
---|---|
Former Legal Business Name | PEACE PAVILION MENTAL HEALTHCARE AND COUNSELING SERVICES PLLC |
Entity Type | Organization |
Authorized Contact | BOLANLE AWOTIKU Pmhnp 630-504-8745 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2023-12-18 |
Last Update Date | 2024-01-03 |