Provider Demographics
NPI:1316576051
Name:EQUANIMITY BEHAVIORAL HEALTH AND CONSULTATION SERVICES
Entity Type:Organization
Organization Name:EQUANIMITY BEHAVIORAL HEALTH AND CONSULTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PACIFICAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NYANGAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-651-8474
Mailing Address - Street 1:2129 FM 2920 RD STE 171
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3671
Mailing Address - Country:US
Mailing Address - Phone:282-651-8474
Mailing Address - Fax:
Practice Address - Street 1:25301 BOROUGH PARK DR STE 220
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3562
Practice Address - Country:US
Practice Address - Phone:281-651-8474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-04
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)