Provider Demographics
NPI:1043937923
Name:SALVAGE PSYCHIATRY A PROFESSIONAL NURSING CORPORATION CORPORATION
Entity Type:Organization
Organization Name:SALVAGE PSYCHIATRY A PROFESSIONAL NURSING CORPORATION CORPORATION
Other - Org Name:SALVAGE NURSING CARE INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/DNP
Authorized Official - Prefix:DR
Authorized Official - First Name:TAIYE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:818-643-4311
Mailing Address - Street 1:19725 SHERMAN WAY STE 295B
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:CA
Mailing Address - Zip Code:91306-3650
Mailing Address - Country:US
Mailing Address - Phone:818-643-4311
Mailing Address - Fax:888-259-4715
Practice Address - Street 1:19725 SHERMAN WAY STE 295B
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:CA
Practice Address - Zip Code:91306-3650
Practice Address - Country:US
Practice Address - Phone:818-643-4311
Practice Address - Fax:888-259-4715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health