1386279875 NPI number — MRS. MARIECLAIRE MBAH ACHA PMHNP

Table of content: MRS. MARIECLAIRE MBAH ACHA PMHNP (NPI 1386279875)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386279875 NPI number — MRS. MARIECLAIRE MBAH ACHA PMHNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ACHA
Provider First Name:
MARIECLAIRE
Provider Middle Name:
MBAH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PMHNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386279875
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HEALTH GARDENS LLC
Provider Second Line Business Mailing Address:
1216 AUTUMN DR
Provider Business Mailing Address City Name:
MANSFIELD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-766-6071
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CBI WEST VALLEY ACCESS POINT
Provider Second Line Business Practice Location Address:
824 N99TH AVE STE 108
Provider Business Practice Location Address City Name:
AVONDALE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-907-1457
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0808X , with the licence number:  AP144914 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 248194 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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