| NPI | 1386485233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER REANN PHEBUS Owner 765-232-3503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2024-06-04 |
| Last Update Date | 2025-06-19 |