| NPI | 1518622802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MARTINEZ CEO 888-660-4425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-12-10 |