Provider Demographics
NPI:1912258369
Name:LONG TERM CARE PSYCHIATRY NURSING CORPORATION
Entity Type:Organization
Organization Name:LONG TERM CARE PSYCHIATRY NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:FALK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:415-528-0532
Mailing Address - Street 1:46 CRAGMONT AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-1308
Mailing Address - Country:US
Mailing Address - Phone:415-823-5131
Mailing Address - Fax:
Practice Address - Street 1:46 CRAGMONT AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94116-1308
Practice Address - Country:US
Practice Address - Phone:415-823-5131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty