Organization
CORAL VITALITY LLC
Active
Organization
CORAL VITALITY LLC
Active
Other names
Coral Vitality LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MANGUAL (PMHNP)
(915) 221-5595
Entity
Organization
Contact information
Practice address
121 WYATT DR STE 18, LAS CRUCES, NM 88005-2961
(575) 570-3671
(575) 232-0631
Mailing address
6204 BRAZOS RIVER ST, EL PASO, TX 79932-1222
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/05/2023
Last updated
08/14/2026
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