Rehoboth Mental Health And Psychiatry PLLC
Nurse Practitioner, Psych/Mental Health in Mansfield, TX. Organization (NPI-2).
NPI number1053156331
StatusActive
Last updated in NPPESDec 16, 2025
Details
- NPI
- 1053156331
- Entity type
- Organization (NPI-2)
- Legal business name
- Rehoboth Mental Health And Psychiatry PLLC
- Organization subpart
- No
- Enumeration date
- Jun 27, 2024
- Certification date
- Dec 16, 2025
- Last updated
- Dec 16, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | Yes |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – |
Practice location
1475 Heritage Pkwy Ste 209Mansfield, TX 76063-2740
Phone 817-523-8812 · Fax 817-241-1947
Mailing address
1475 Heritage Pkwy Ste 209Mansfield, TX 76063-2740
Phone 817-523-8812
Other practice locations
5900 Balcones Dr
Austin, TX 78731-4257
Austin, TX 78731-4257
Phone 817-523-8812
Authorized official
Omotayo Gbengaojo
Owner/Authorised Official
8175238812
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