| NPI | 1538953245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHELLE LATOYA JACKSON Owner 404-480-2760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center Urgent Care |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2025-04-07 |
| Last Update Date | 2025-04-07 |