Amity Mental Wellness LLC
Nurse Practitioner, Psych/Mental Health in Salem, OR. Organization (NPI-2).
NPI number1417736620
StatusActive
Last updated in NPPESSep 26, 2023
Details
- NPI
- 1417736620
- Entity type
- Organization (NPI-2)
- Legal business name
- Amity Mental Wellness LLC
- Organization subpart
- No
- Enumeration date
- Sep 26, 2023
- Certification date
- Sep 26, 2023
- Last updated
- Sep 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
Practice location
147 Commercial St Ne Ste 7Salem, OR 97301-3418
Phone 813-458-7232
Mailing address
147 Commercial St Ne Ste 7Salem, OR 97301-3418
Phone 813-458-7232
Authorized official
Lauri Cody
Owner Of Entity
8134587232
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