| NPI | 1649005000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MAYES Owner 161-435-3615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 347C00000X Private Vehicle | |
| 347E00000X Transportation Broker | |
| 251B00000X Case Management | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 385H00000X Respite Care | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2026-05-11 |