NPIMap

Organization Active NPI

Grand Vista Behavioral Health Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Richmond, TX
National Provider Identifier
1366182164
Registry record updated May 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GRAND VISTA BEHAVIORAL HEALTH CENTER LLC
Practice address
9711 S Mason Rd Ste 125-215
Richmond, TX 77407-7167
Phone
(346) 933-2463
Fax
(713) 234-7382
NPI assigned
Mar 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Blessing Uchechukwu Smith, APRNNPI 1649770165
Title
Pmhnp-BC
Phone
(832) 352-0845

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

9711 S Mason Rd Ste 125-215
Richmond, TX 77407-7167

Mailing address

9711 S Mason Rd Ste 125-215
Richmond, TX 77407-7167
Phone (346) 933-2463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20221013001275 TX Part B Supplier - Clinic/Group Practice 6507232758 Receives reassigned benefits from 4 practitioners
Practice locations: Richmond, TX
O20221130002517 KS Part B Supplier - Clinic/Group Practice 6507232758 Receives reassigned benefits from 1 practitioner
Practice locations: Wichita, KS

National Provider Directory

National Provider Directory

Locations

4925 S Broadway Ave
Wichita, KS 67216
Phone (316) 227-1989

9711 S Mason Rd
Ste 125215
Richmond, TX 77407
Phone (346) 933-2463

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651363200000",
    "number": "1366182164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 S MASON RD STE 125-215",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774077167",
            "telephone_number": "346-933-2463",
            "fax_number": "713-234-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 S MASON RD STE 125-215",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774077167",
            "telephone_number": "346-933-2463",
            "fax_number": "713-234-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND VISTA BEHAVIORAL HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BLESSING",
        "authorized_official_middle_name": "UCHECHUKWU",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "832-352-0845",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.