| NPI | 1841166832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSANDRE HENRY Owner 772-834-6965 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251B00000X Case Management |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-10-15 |
| Last Update Date | 2025-10-15 |