Organization
NICHE MEDICAL ACADEMY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUSEBIUS UCHE OJONTA (PRESIDENT)
(281) 339-4250
Entity
Organization
Contact information
Practice address
7066 LAKEVIEW HAVEN DR STE 125B, HOUSTON, TX 77095-2560
(281) 300-4250
Mailing address
7066 LAKEVIEW HAVEN DR STE 125B, HOUSTON, TX 77095-2560
(281) 300-4250
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32058967491
HCBS
TX
Enumeration date
11/21/2018
Last updated
11/21/2018
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