| NPI | 1346795325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS DARLENE NELSON CEO/Manager 385-335-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2023-01-28 |