Provider Demographics
NPI:1194573956
Name:GLOXEL MENTAL AND BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:GLOXEL MENTAL AND BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:OFONIME
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:EKPE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:859-780-5947
Mailing Address - Street 1:7103 TURFWAY RD # L1
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2094
Mailing Address - Country:US
Mailing Address - Phone:859-780-5947
Mailing Address - Fax:859-955-5064
Practice Address - Street 1:7103 TURFWAY RD # L1
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2094
Practice Address - Country:US
Practice Address - Phone:859-780-5947
Practice Address - Fax:859-955-5064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)