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Organization
HEROIC MENTAL HEALTH LLC
Active
Organization
HEROIC MENTAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIKA OGBOLU NP (OWNER/PROVIDER)
(757) 737-3134
Entity
Organization
Contact information
Practice address
425 W WASHINGTON ST STE 4, SUFFOLK, VA 23434-5320
(757) 737-3134
Mailing address
425 W WASHINGTON ST STE 4, SUFFOLK, VA 23434-5320
(757) 737-3134
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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