| NPI | 1124814462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL KOFI JACKSON NSIAH CEO 929-203-5657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-15 |
| Last Update Date | 2025-05-03 |