| NPI | 1952121386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERTRUDE JANUARY Owner 725-910-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SC1501X Clinical Nurse Specialist, Community Health/Public Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2024-10-11 |