| NPI | 1750144333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADETTE MOMOH Owner 267-485-5227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| 363LP2300X Nurse Practitioner Primary Care | |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2025-06-12 |