NPI | 1124885348 |
---|---|
Entity Type | Organization |
Authorized Contact | KEISHA ELLIS Authorized Official/Owner 954-335-3131 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2024-03-04 |
Last Update Date | 2024-03-04 |