| NPI | 1679141774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANESSA HOLMAN Ap RN/Owner 270-713-0799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-09-10 |