| NPI | 1275161366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKAETE OYEKA Pmhnp Bc 877-219-2519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-05-22 |