| NPI | 1427521426 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NJIDEKA DOMRUFUS Psychiatric Nurse Practitionier 817-524-7107 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health | 
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health | 
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2019-01-02 | 
| Last Update Date | 2022-03-09 |