Provider Demographics
NPI:1194275180
Name:MHLA, A NURSING CORPORATION
Entity type:Organization
Organization Name:MHLA, A NURSING CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ANDRENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGROARTY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:818-465-9996
Mailing Address - Street 1:5848 E NAPLES PLZ
Mailing Address - Street 2:201
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5000
Mailing Address - Country:US
Mailing Address - Phone:818-465-9996
Mailing Address - Fax:562-386-2114
Practice Address - Street 1:5848 E NAPLES PLZ
Practice Address - Street 2:201
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5000
Practice Address - Country:US
Practice Address - Phone:818-465-9996
Practice Address - Fax:562-386-2114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-13
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF21499363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty