NPI | 1104570233 |
---|---|
Doing Business As | SOUTHERN OASIS BH, LLC |
Entity Type | Organization |
Authorized Contact | LUIZA ASAHME Provider/Owner 917-669-8305 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2022-02-08 |
Last Update Date | 2022-02-08 |