| NPI | 1316540495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHA PRESTON Nurse Practitioner 580-504-1517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101Y00000X Counselor |
| 163W00000X Registered Nurse | |
| 163WA0400X Registered Nurse Addiction (Substance Use Disorder) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 261Q00000X Clinic/Center | |
| 261QH0100X Clinic/Center Health Service | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2024-07-30 |