NPI | 1437783529 |
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Doing Business As | TELEMENTAL HEALTH LINK - NM |
Former Legal Business Name | PSYCHIATRIC NURSE PRACTITIONER SERVICES LLC |
Entity Type | Organization |
Authorized Contact | SUSAN M DERIVAS AO 208-775-7418 |
Organization Subpart ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
Enumeration Date | 2020-02-27 |
Last Update Date | 2024-02-07 |