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General NPI Number Information
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NPI Number | 1336535947
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Entity Type | Organization
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Legal Business Name | COALITION OF REGISTERED NURSES 4 HEALTHY COMMUNITIES
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Dates
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Enumeration Date | 04/09/2015
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 21495 DICKINSON RD
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City | MORENO VALLEY
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State | CA
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Zip | 92557-8421
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Country | US
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Telephone | 951-779-1304
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Fax |
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Provider Business Mailing Address
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Address Line | 21495 DICKINSON RD
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City | MORENO VALLEY
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State | CA
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Zip | 92557-8421
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Country | US
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Telephone | 951-779-1304
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. LOUISE BLACK ROBINSON
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Credential | DNP., CNS., RN
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Telephone | 951-779-1304
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 285031; 1888
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License Number State | CA
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