Prime Mind Health Services LLC
Nurse Practitioner, Psych/Mental Health in Chicago, IL. Organization (NPI-2).
NPI number1144909151
StatusActive
Last updated in NPPESJul 17, 2023
Details
- NPI
- 1144909151
- Entity type
- Organization (NPI-2)
- Legal business name
- Prime Mind Health Services LLC
- Organization subpart
- No
- Enumeration date
- Jul 17, 2023
- Certification date
- Jul 17, 2023
- Last updated
- Jul 17, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
230 E Ohio St Ste 410Chicago, IL 60611-5288
Phone 312-678-4449
Mailing address
230 E Ohio St Ste 410Chicago, IL 60611-5288
Phone 312-678-4449
Authorized official
Comfort Lacy
Owner
3126784449
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