Healthcare Provider Details

I. General information

NPI: 1396425740
Provider Name (Legal Business Name): CIP HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14090 SOUTHWEST FWY STE 300
SUGAR LAND TX
77478-3679
US

IV. Provider business mailing address

675 ALPHA DR STE G
HIGHLAND HTS OH
44143-2139
US

V. Phone/Fax

Practice location:
  • Phone: 346-348-0308
  • Fax:
Mailing address:
  • Phone: 216-323-0028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHINYERE IHEJIRIKA
Title or Position: PMHNP
Credential: NP
Phone: 216-323-0028