| NPI | 1477261923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MOODY Owner 605-277-1190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2023-05-03 |