| NPI | 1699350918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALEA L BROWN Executive Director/Provider 731-693-2047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |