| NPI | 1669254546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIA R BOWLING Owner 765-827-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2025-06-30 |