| NPI | 1336912732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA MYRIE CEO 833-294-6969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2023-11-07 |