| NPI | 1386485233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER REANN PHEBUS CEO 765-418-7477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2024-08-16 |