NPI | 1508640996 |
---|---|
Entity Type | Organization |
Authorized Contact | JACQUELINE PORTER Administrator 800-688-0388 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
163WM0705X Registered Nurse, Medical-Surgical | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
261QM2500X Clinic/Center, Medical Specialty | |
261QM0850X Clinic/Center, Adult Mental Health | |
282J00000X Religious Nonmedical Health Care Institution | |
3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
343900000X Non-emergency Medical Transport (VAN) | |
364SM0705X Clinical Nurse Specialist, Medical-Surgical | |
363LP2300X Nurse Practitioner, Primary Care | |
Enumeration Date | 2023-08-24 |
Last Update Date | 2023-08-24 |