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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