Individual
JENS MONROE NELSON
Active
Individual
JENS MONROE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
519113
OR
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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