Organization · NPI-2

Spg Pm2 Services

Nurse Practitioner, Psych/Mental Health · Buckeye, AZ

NPI number1669110623
StatusActive
Last updated in NPPESMay 20, 2022

Details

NPI
1669110623
Entity type
Organization (NPI-2)
Legal business name
Spg Pm2 Services
Organization subpart
No
Enumeration date
May 20, 2022
Certification date
May 20, 2022
Last updated
May 20, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0808X Nurse Practitioner, Psych/Mental Health––Yes
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––

Other names

  • Spg Pm2 Services (Doing Business As)

Practice location

2587 N Beverly Pl
Buckeye, AZ 85396-1793

Phone 210-380-2107

Mailing address

2587 N Beverly Pl
Buckeye, AZ 85396-1793

Phone 210-380-2107

Authorized official

Shawn Patrick Gallagher
Psychiatric-Mental Health NP/Owner
2103802107

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