| NPI | 1225902455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MATES Owner 937-542-9246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 207QA0505X Family Medicine, Adult Medicine | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2025-10-01 |
| Last Update Date | 2025-11-06 |