| NPI | 1922876895 |
|---|---|
| Doing Business As | WATERSIDE HEALTHCARE SERVICES INC |
| Entity Type | Organization |
| Authorized Contact | TAIWO ODUKOYA ODUTOLA Np 310-927-2119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |