| NPI | 1740026541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY DIANE HUBBARD President 912-223-5970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-10-08 |