| NPI | 1801546718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TWYLA NEWMAN CEO 863-812-0471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-03-24 |