| NPI | 1629769609 |
|---|---|
| Doing Business As | LTA PSYCHIATRIC WELLNESS CENTER LLC |
| Entity Type | Organization |
| Authorized Contact | OLAYEMI O ONONOGBU Owner 833-582-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2024-06-25 |