NPI | 1831830231 |
---|---|
Entity Type | Organization |
Authorized Contact | BOLA OSUNKIYESI Owner 985-464-9810 |
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 | 2022-04-07 |
Last Update Date | 2025-09-22 |