# PBN UNIVERSAL HEALING LLC

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

## Provider details

- **NPI number:** 1790503795
- **Authorized official:** PROSCOVIA B LUBWAMA PMHNP (NP)
- **Authorized official phone:** (818) 401-3293

## Contact information

- **Practice address:** 9313 S 39TH DR, LAVEEN, AZ 85339-1237
- **Practice address phone:** (818) 401-3293
- **Mailing address:** 6200 DE SOTO AVE APT 35103, WOODLAND HILLS, CA 91367-0202
- **Mailing address phone:** (818) 401-3293

## 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:** 09/30/2024
- **Last updated:** 09/30/2024