| NPI | 1326913674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA GAIL DASHNER Cmo/Provider 772-216-3123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WW0000X Registered Nurse, Wound Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-10-07 |
| Last Update Date | 2025-10-07 |