Organization
DIVINE MENTAL HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURETTA STUBBS NP (OWNER)
(915) 820-0315
Entity
Organization
Contact information
Practice address
1900 N MESA ST STE C, EL PASO, TX 79902-3309
(915) 820-0315
Mailing address
1504 PETAYA LN, EL PASO, TX 79912-8497
(915) 820-0315
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/27/2023
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