| Grand Vista Behavioral Health Center Llc | |
|
9711 S Mason Rd Ste 125-215 Richmond TX 77407-7167 | |
| (346) 933-2463 | |
| (713) 234-7382 |
| Full Name | Grand Vista Behavioral Health Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9711 S Mason Rd Ste 125-215, Richmond, Texas |
| Authorized Official Name and Position | Blessing Uchechukwu Smith (PMHNP-BC) |
| Authorized Official Contact | 8323520845 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Vista Behavioral Health Center Llc 9711 S Mason Rd Ste 125-215 Richmond TX 77407-7167 Ph: (346) 933-2463 | Grand Vista Behavioral Health Center Llc 9711 S Mason Rd Ste 125-215 Richmond TX 77407-7167 Ph: (346) 933-2463 |
| NPI Number | 1366182164 |
|---|---|
| Provider Enumeration Date | 03/30/2022 |
| Last Update Date | 05/01/2022 |
| Certification Date | 05/01/2022 |
| Medicare PECOS PAC ID | 6507232758 |
|---|---|
| Medicare Enrollment ID | O20221013001275 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366182164 | NPI | - | NPPES |
| Provider Name | Blessing Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649770165 PECOS PAC ID: 6305184672 Enrollment ID: I20190212000861 |
| Provider Name | Cecilia Ufot Ragsdale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588329700 PECOS PAC ID: 5597159137 Enrollment ID: I20220225000185 |
| Provider Name | Racheal Forghab Kedze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700443736 PECOS PAC ID: 9537545645 Enrollment ID: I20220927002280 |
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