| NPI | 1689473878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL LACUESTA CEO 747-370-6986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-11-17 |