# RENASCENT BEHAVIORAL HEALTH CLINIC

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

## Provider details

- **NPI number:** 1780348029
- **Authorized official:** ISAAC OLUFEMI OGUNSEYITAN PMHNP-BC (CEO)
- **Authorized official phone:** (817) 703-5890

## Contact information

- **Practice address:** 539 W COMMERCE ST STE 3448, DALLAS, TX 75208-1953
- **Practice address phone:** (817) 904-4536
- **Mailing address:** 539 W COMMERCE ST STE 3448, DALLAS, TX 75208-1953
- **Mailing address phone:** (817) 904-4536

## 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:** 10/22/2021
- **Last updated:** 10/22/2021