NPI | 1225719677 |
---|---|
Entity Type | Organization |
Authorized Contact | TINA WILLIAMS CEO/Owner/Operator 336-253-8252 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
261QM1300X Clinic/Center, Multi-Specialty | |
363LP1700X Nurse Practitioner, Perinatal | |
Enumeration Date | 2023-07-28 |
Last Update Date | 2023-07-28 |