Healthcare Provider Details

I. General information

NPI: 1437976941
Provider Name (Legal Business Name): NORAH COMP MENTAL HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11403 OAK LAKE POINT DR
SUGAR LAND TX
77498-7001
US

IV. Provider business mailing address

11403 OAK LAKE POINT DR
SUGAR LAND TX
77498-7001
US

V. Phone/Fax

Practice location:
  • Phone: 206-313-6816
  • Fax:
Mailing address:
  • Phone: 832-326-5251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHITOM PEARL AZUBIKE
Title or Position: PSYCHIATRIC NURSE PRACTITIONER
Credential: PMHNP-BC
Phone: 832-651-0491