NPI | 1205375862 |
---|---|
Entity Type | Organization |
Authorized Contact | DOROTHY CRISOSTOMO CEO 678-908-0006 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: GA RN141244) |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2017-02-15 |
Last Update Date | 2023-10-24 |