| NPI | 1902670490 |
|---|---|
| Doing Business As | BUSINESS OWNER |
| Entity Type | Organization |
| Authorized Contact | RALPH OGWOTU Business Owner 404-734-4445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2025-06-17 |