| NPI | 1275409468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODROS MENGESHA Owner, Authorized Official 256-469-1446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2025-10-14 |