| NPI | 1740056498 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JOHN YEE Owner 386-424-3320  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2023-12-04 | 
| Last Update Date | 2025-03-26 |