# CARDINAL SUPPORT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** EASE PSYCHIATRY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699312314
- **Authorized official:** DR. NWAMAKA LARVINE EMERUEM DNP (DIRECTOR)
- **Authorized official phone:** (972) 503-4109

## Contact information

- **Practice address:** 2512 E EVERGREEN BLVD, VANCOUVER, WA 98661-4323
- **Practice address phone:** (972) 503-4109
- **Practice address fax:** (972) 449-0500
- **Mailing address:** 2804 S LAKEVIEW DR, CEDAR HILL, TX 75104-8233
- **Mailing address phone:** (972) 503-4109

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261Q00000X | Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2019
- **Last updated:** 05/21/2024