| NPI | 1770096828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARLENE ARETHA TAYLOR ROSE Owner 424-209-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 251J00000X Nursing Care | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 261QP2300X Clinic/Center, Primary Care | |
| 305S00000X Point of Service | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2022-01-24 |