| NPI | 1225754849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDIA SAMUELS Np 800-983-3846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 202D00000X | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2025-03-25 |