Organization
AVA BEHAVIORAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR AZUBIKE AMOBI NURSE PRACTITIONER (PRESIDENT)
(240) 423-6528
Entity
Organization
Contact information
Practice address
9825 SAMANTHA SUZANNE CT, HOUSTON, TX 77025-1507
(240) 423-6528
Mailing address
9825 SAMANTHA SUZANNE CT, HOUSTON, TX 77025-1507
(240) 423-6528
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-510-847-079-447
TEXAS DRIVER'S LICENSE
MD
Enumeration date
09/11/2021
Last updated
09/11/2021
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