Organization
CARDINAL SUPPORT LLC
Active
Other names
EASE PSYCHIATRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NWAMAKA LARVINE EMERUEM DNP (DIRECTOR)
(972) 503-4109
Entity
Organization
Contact information
Practice address
2512 E EVERGREEN BLVD, VANCOUVER, WA 98661-4323
(972) 503-4109
(972) 449-0500
Mailing address
2804 S LAKEVIEW DR, CEDAR HILL, TX 75104-8233
(972) 503-4109
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/01/2019
Last updated
05/21/2024
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