| NPI | 1750907879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELILE SIBUSISIWE NKOLOMI CEO 469-733-2090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-07-11 |