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General NPI Number Information
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NPI Number | 1215492673
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Entity Type | Organization
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Legal Business Name | SIMON PSYCHIATRIC CARE INC
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Dates
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Enumeration Date | 02/08/2019
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 514 HIGH ST
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City | WAYNESVILLE
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State | OH
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Zip | 45068-9784
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Country | US
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Telephone | 937-985-4743
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Fax |
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Provider Business Mailing Address
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Address Line | 714 E MONUMENT AVE
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City | DAYTON
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State | OH
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Zip | 45402-1382
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Country | US
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Telephone | 937-985-4743
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA LYNN AL-HAMDANI
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Credential | NP-C
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Telephone | 937-985-4743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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