Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Recovery Care |
261QR0800X |
| NPI Number | 1548097074 |
| LBN Legal business name | CARISSA MILLER |
| Authorized official | CARISSA MILLER - (SOLE PROPRIETOR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/18/2024 |
| Last updated | 09/18/2024 - More than a year ago |
| Identifiers | n/a |
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