| NPI | 1902778079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY WRATHER Owner 270-576-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 101YM0800X Counselor, Mental Health | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 101Y00000X Counselor | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 1835P2201X Pharmacist, Ambulatory Care | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 1041C0700X Social Worker, Clinical | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2025-09-19 |
| Last Update Date | 2025-12-17 |