Organization
NIOSTAR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHISOMNAZU WINIFRED IWEHA-ONONYE NP (DIRECTOR)
(248) 890-2078
Entity
Organization
Contact information
Practice address
11974 N 158TH LN, SURPRISE, AZ 85379-1067
(248) 890-2078
Mailing address
11974 N 158TH LN, SURPRISE, AZ 85379-1067
(248) 890-2078
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
AP4314
AZ
Other
Enumeration date
02/24/2014
Last updated
02/24/2014
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