=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235940834
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NIRVANA PSYCHIATRY AND BEHAVIORAL CENTER INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/14/2025
-----------------------------------------------------
Last Update Date | 01/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5605 SPRING KNOLL CT
-----------------------------------------------------
City | ROSHARON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77583-2163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-751-9616
-----------------------------------------------------
Fax | 877-552-0224
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5605 SPRING KNOLL CT
-----------------------------------------------------
City | ROSHARON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77583-2163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-751-9616
-----------------------------------------------------
Fax | 877-552-0224
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | NP
-----------------------------------------------------
Name | NNENNAYA OJINGWA
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 713-751-9616
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------