Organization
EDEN'S VANTAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL E. OKON CNP (CEO)
(469) 569-5148
Entity
Organization
Contact information
Practice address
2553 PETTUS DR, FORNEY, TX 75126-4172
(469) 569-5148
Mailing address
2553 PETTUS DR, FORNEY, TX 75126-4172
(469) 569-5148
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/23/2021
Last updated
09/08/2022
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