# MMCMLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mantality Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477104487
- **Authorized official:** SANDY HARDMAN (CREDENTIALING MANAGER)
- **Authorized official phone:** (314) 254-2420

## Contact information

- **Practice address:** 4173 CRESCENT DR STE A, SAINT LOUIS, MO 63129-1082
- **Practice address phone:** (314) 254-2420
- **Mailing address:** 4173 CRESCENT DR STE A, SAINT LOUIS, MO 63129-1082
- **Mailing address phone:** (314) 254-2420

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/23/2019
- **Last updated:** 09/23/2019