Provider Demographics
NPI:1205417573
Name:GIVINGHOPE BEHAVIORAL HEALTH INC
Entity Type:Organization
Organization Name:GIVINGHOPE BEHAVIORAL HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LATIFAT
Authorized Official - Middle Name:FOLASHADE
Authorized Official - Last Name:ADELEKAN-ADEOGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-578-2132
Mailing Address - Street 1:404 E BROAD ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-1743
Mailing Address - Country:US
Mailing Address - Phone:319-600-6693
Mailing Address - Fax:
Practice Address - Street 1:539 W COMMERCE ST STE 4934
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-1953
Practice Address - Country:US
Practice Address - Phone:222-441-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-19
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty