Provider Demographics
NPI:1609629948
Name:LILIUM PSYCHIATRIC NURSING SERVICES
Entity Type:Organization
Organization Name:LILIUM PSYCHIATRIC NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:KAILI-OVERLIE
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:858-209-9871
Mailing Address - Street 1:2382 FARADAY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7219
Mailing Address - Country:US
Mailing Address - Phone:858-209-9871
Mailing Address - Fax:858-939-1595
Practice Address - Street 1:2382 FARADAY AVE STE 100
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7219
Practice Address - Country:US
Practice Address - Phone:858-209-9871
Practice Address - Fax:858-939-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty