| NPI | 1780441519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY TRAN Owner 813-520-7092 |
| 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 | 2024-02-28 |
| Last Update Date | 2024-05-22 |