| NPI | 1427848399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANIKA GREEN President 667-273-5407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-06-26 |