| NPI | 1942051396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANDERSON President 855-380-6136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103K00000X Behavior Analyst | |
| 1041C0700X Social Worker Clinical | |
| 133NN1002X Nutritionist Nutrition, Education | |
| 133V00000X Dietitian, Registered | |
| 261QC1500X Clinic/Center Community Health | |
| 261QP2300X Clinic/Center Primary Care | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-08-06 |