Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Intellectual & Developmental Disabilities |
103TM1800X | 62 | Psychologist, Clinical |
| NPI # | 1255516621 |
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| LBN Legal business name | MERRICK CARE CORP | ||||
| Authorized official | URUM URUM-EKE - (OWNER/ADMINISTRATOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/04/2008 | ||||
| Last updated | 01/04/2008 - About 18 years ago | ||||
| Identifiers |
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