| Divine Race Mental Health Services | |
|
10193 W Grand Pkwy S Ste 103202 Richmond TX 77407-8685 | |
| (832) 693-7100 | |
| Not Available |
| Full Name | Divine Race Mental Health Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 10193 W Grand Pkwy S Ste 103202, Richmond, Texas |
| Authorized Official Name and Position | Annastecia Chinasa Okibe (PSYCH NURSE PRACTITIONER) |
| Authorized Official Contact | 8326927100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Race Mental Health Services 10193 W Grand Pkwy S Ste 103202 Richmond TX 77407-8685 Ph: (832) 693-7100 | Divine Race Mental Health Services 10193 W Grand Pkwy S Ste 103202 Richmond TX 77407-8685 Ph: (832) 693-7100 |
| NPI Number | 1275256976 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 09/19/2022 |
| Certification Date | 09/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275256976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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