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Organization
CARDINAL SUPPORT LLC
Active
Organization
CARDINAL SUPPORT LLC
Active
Other names
EASE PSYCHIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NWAMAKA LARVINE EMERUEM DNP (DIRECTOR)
(972) 503-4109
Entity
Organization
Contact information
Practice address
2512 E EVERGREEN BLVD, VANCOUVER, WA 98661-4323
(972) 503-4109
(972) 449-0500
Mailing address
2804 S LAKEVIEW DR, CEDAR HILL, TX 75104-8233
(972) 503-4109
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/01/2019
Last updated
05/21/2024
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