| NPI | 1699529198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAKESA A TOURE Owner 302-217-6618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-08-30 |