NPI | 1710545488 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAMECA L HUDSON Chief Executive Officer 769-572-4009 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2019-05-29 |
Last Update Date | 2024-10-04 |