Organization
MO BETHEL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORITSEMOYOGBEMI NAGOCSON EDEMA (MANAGING MEMBER)
(713) 459-7861
Entity
Organization
Contact information
Practice address
5214 ROLLINGSTONE RD, RICHMOND, TX 77407-4133
(713) 459-7861
(281) 857-6658
Mailing address
5214 ROLLINGSTONE RD, RICHMOND, TX 77407-4133
(713) 459-7861
(281) 857-6658
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
TX
Other
Enumeration date
08/16/2009
Last updated
08/16/2009
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