| NPI | 1851113849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIMEON MERTYL Director 888-344-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult |
| Additional Taxonomies | 163WG0600X Registered Nurse, Gerontology |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |