| NPI | 1831922624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE NA Owner 602-500-1264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-09-10 |