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1104593789
EDEN'S VANTAGE LLC
FORNEY, TX
NPI
1104593789
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Entity Type
Organization
Authorized Contact
EMMANUEL E. OKON
CEO
469-569-5148
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2021-08-23
Last Update Date
2022-09-08
Business Address
EDEN'S VANTAGE LLC
2553 PETTUS DR
FORNEY, TX 75126-4172
Phone number: 469-569-5148
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Mailing Address
EDEN'S VANTAGE LLC
2553 PETTUS DR
FORNEY, TX 75126-4172
Phone number: 469-569-5148
Copy
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