NPI | 1184381790 |
---|---|
Entity Type | Organization |
Authorized Contact | NICOLE MILLER Nurse Practitioner 267-331-0660 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2021-11-18 |
Last Update Date | 2021-11-18 |