Provider Demographics
NPI:1013693373
Name:EVER FLOURISH MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:EVER FLOURISH MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:OYEWOLE
Authorized Official - Middle Name:GBENGA
Authorized Official - Last Name:OGUNNAIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-215-6450
Mailing Address - Street 1:125 EUGENE ONEILL DR
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:CT
Mailing Address - Zip Code:06320-6410
Mailing Address - Country:US
Mailing Address - Phone:956-215-6450
Mailing Address - Fax:844-321-6166
Practice Address - Street 1:125 EUGENE ONEILL DR
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-6410
Practice Address - Country:US
Practice Address - Phone:956-215-6450
Practice Address - Fax:844-321-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty