# MICHAEL S LONG LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407436223
- **Authorized official:** MICHAEL LONG (OWNER)
- **Authorized official phone:** (210) 200-9864

## Contact information

- **Practice address:** 9330 ARDEN BND, SAN ANTONIO, TX 78250-2710
- **Practice address phone:** (210) 200-9864
- **Mailing address:** 9330 ARDEN BND, SAN ANTONIO, TX 78250-2710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/14/2021
- **Last updated:** 04/14/2021