# ARISE PSYCHIATRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336998236
- **Authorized official:** ADAOBI MOEMENAM NURSE PRACTITIONER (NP/MANAGER)
- **Authorized official phone:** (310) 800-8445

## Contact information

- **Practice address:** 1617 PARK PLACE AVE, SUITE \#110, FORT WORTH, TX 76110
- **Practice address phone:** (682) 302-0301
- **Mailing address:** 200 S OAKRIDGE DR STE 101, HUDSON OAKS, TX 76087-2501
- **Mailing address phone:** (310) 800-8445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2024
- **Last updated:** 05/14/2024