| NPI | 1992411904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANELLE DEBYE Member/Provider/CEO 833-906-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-01-24 |