NPI | 1902375900 |
---|---|
Entity Type | Organization |
Authorized Contact | DEMETRIS WRIGHT President 803-728-0142 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
363LF0000X Nurse Practitioner Family | |
Enumeration Date | 2018-11-19 |
Last Update Date | 2024-08-20 |