| NPI | 1386355766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEIDY RIVERS Owner 813-400-8632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2022-12-07 |
| Last Update Date | 2024-03-23 |