| NPI | 1154011617 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERENDA MARIE BEASLEY CEO 334-648-8779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2023-05-09 |