| NPI | 1477318517 |
|---|---|
| Other Name | SARA R. VAN KONINGSVELD |
| Entity Type | Organization |
| Authorized Contact | SARA ROSE VAN KONINGSVELD President/Founder 424-442-9842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-02-19 |