| NPI | 1851909170 |
|---|---|
| Doing Business As | SUPREME PSYCHIATRY SERVICES |
| Entity Type | Organization |
| Authorized Contact | ELO OMAKOR CEO 682-272-5143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2022-04-11 |