| NPI | 1538898630 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN THOMAS Nurse Practitioner 772-777-0351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| 261QP2300X Clinic/Center Primary Care | |
| 261QU0200X Clinic/Center Urgent Care | |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2025-05-02 |