| NPI | 1821961020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DYANA KO President 424-728-5564 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-09-25 |