| NPI | 1609412154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL DAWN WHITEHOUSE Ap RN, Owner 270-315-7208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2021-01-27 |