| NPI | 1780465559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN AUGUSTIN Owner, CEO 954-461-3172 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2023-10-09 |