NPI | 1831841626 |
---|---|
Doing Business As | MIND HAVEN |
Entity Type | Organization |
Authorized Contact | MARLISHA LORRAINE THOMAS Owner/ Provider 662-440-0301 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
Enumeration Date | 2022-01-22 |
Last Update Date | 2022-02-15 |