Provider Demographics
NPI:1376390153
Name:JUPCO BEHAVIORAL HEALTHCARE SERVICES
Entity type:Organization
Organization Name:JUPCO BEHAVIORAL HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNBOSCO
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYCHIATRIC NURSE NP
Authorized Official - Phone:281-624-8459
Mailing Address - Street 1:5110 RUBY ROCK WAY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4136
Mailing Address - Country:US
Mailing Address - Phone:281-624-8459
Mailing Address - Fax:
Practice Address - Street 1:5110 RUBY ROCK WAY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4136
Practice Address - Country:US
Practice Address - Phone:281-624-8459
Practice Address - Fax:631-350-0457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty