| NPI | 1831830231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLA OSUNKIYESI President 443-469-9528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-04-08 |