| 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 |