| NPI | 1245941384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNMICHAEL KIMANI Administrator 508-484-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2022-12-09 |