Provider Demographics
NPI:1205691136
Name:MINDHAVEN BEHAVIORAL HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:MINDHAVEN BEHAVIORAL HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHINWE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSUAGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-736-1121
Mailing Address - Street 1:16615 BLUE NILE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5163
Mailing Address - Country:US
Mailing Address - Phone:512-736-1121
Mailing Address - Fax:
Practice Address - Street 1:12333 SOWDEN RD STE B514187
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-2058
Practice Address - Country:US
Practice Address - Phone:346-732-9227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty