| NPI | 1417637042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVERN WILSON-DENNIS CEO 646-244-3196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-12-04 |