# MENTELE HEALTHY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245089093
- **Authorized official:** LYDIA MARIE HAMMOND PMHNP (OWNER/PROVIDER)
- **Authorized official phone:** (520) 329-2341

## Contact information

- **Practice address:** 5035 COPPER BAR RD, LAS CRUCES, NM 88011-9391
- **Practice address phone:** (520) 329-2341
- **Practice address fax:** (680) 766-1757
- **Mailing address:** 5035 COPPER BAR RD, LAS CRUCES, NM 88011-9391
- **Mailing address phone:** (520) 329-2341
- **Mailing address fax:** (680) 766-1757

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/15/2024
- **Last updated:** 06/07/2024