| 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 | 251B00000X Case Management |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2025-05-19 |