| NPI | 1861131583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYSSA BROOKS Sole Member 954-600-2756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2023-01-30 |