Provider Demographics
NPI: | 1023718640 |
---|---|
Name: | CALM CORNER MENTAL HEALTH |
Entity type: | Organization |
Organization Name: | CALM CORNER MENTAL HEALTH |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | NP-PSYCHIATRIC MH |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMARACHI |
Authorized Official - Middle Name: | E |
Authorized Official - Last Name: | IGWE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PMHNP |
Authorized Official - Phone: | 424-375-5129 |
Mailing Address - Street 1: | 9339 ALONDRA BLVD APT 1 |
Mailing Address - Street 2: | |
Mailing Address - City: | BELLFLOWER |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90706-4350 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 424-375-5129 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9339 ALONDRA BLVD SUITE 1 |
Practice Address - Street 2: | SUITE 1 |
Practice Address - City: | BELLFLOWER |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90706 |
Practice Address - Country: | US |
Practice Address - Phone: | 323-770-9175 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-03-03 |
Last Update Date: | 2023-03-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Single Specialty |