| NPI | 1457130676 |
|---|---|
| Doing Business As | KAIROS MOMENT HEALTHCARE AND BEHAVIORAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | ADESOLA IZASOMEH Nurse Practitioner 602-410-0958 |
| 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 | 2023-09-26 |
| Last Update Date | 2024-07-25 |