NPI | 1598558694 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES DAVID MILACEK Provider / Owner 623-229-2175 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2025-05-22 |
Last Update Date | 2025-05-22 |