| NPI | 1932945243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY R WILLLIAMS Managing Partner 844-425-9777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-07-05 |
| Last Update Date | 2024-09-23 |