| NPI | 1194938332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERRY MENDEN Nurse Practitioner 1619-718-9890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: CA 505812) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2008-07-23 |