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Organization
MENTIS NEURO EL PASO, LLC
Active
Organization
MENTIS NEURO EL PASO, LLC
Active
Other names
Mentis Neuro Health
Organization subpart
No
Provider details
NPI number
Authorized official
MARK L. QUIGLEY (CHIEF OPERATING OFFICER)
(713) 864-8996
Entity
Organization
Contact information
Practice address
4360 DONIPHAN DRIVE, EL PASO, TX 79922
(915) 351-4441
Mailing address
6565 WEST LOOP SOUTH, STE. 410, BELLAIRE, TX 77401-3519
(713) 820-4200
(713) 820-4220
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH005B
BLUE CROSS
TX
Enumeration date
06/15/2007
Last updated
09/08/2016
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