| NPI | 1174316657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PEARL ALWENY Owner 857-316-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-08-25 |