Organization
BRAIN HEAVEN WITH ADONAI A NURSING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISA MCKNIGHT PMHNP-MSN (CEO)
(209) 470-6692
Entity
Organization
Contact information
Practice address
17875 VON KARMAN AVE STE 150, IRVINE, CA 92614-6212
(949) 694-9449
Mailing address
17875 VON KARMAN AVE STE 150, IRVINE, CA 92614-6212
(949) 694-9449
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/08/2024
Last updated
06/25/2024
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