| NPI | 1417671421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEMOLA SOLOMON OBELE Owner/Provider 508-615-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2023-10-21 |