| NPI | 1275005456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY KIMUYU Pmhnp Bc/Fnp Bc 682-518-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-12-27 |
| Last Update Date | 2019-03-24 |