Organization
MIND & BODY HEALTHCARE LLC
Active
Other names
Jon Perry MPAS C-PA
Organization subpart
No
Provider details
NPI number
Authorized official
JON E PERRY PA (OWNER)
(575) 489-4750
Entity
Organization
Contact information
Practice address
1700 N UNION AVE, ROSWELL, NM 88201-3267
(575) 489-4750
(575) 586-4414
Mailing address
714 GARDEN PL, ROSWELL, NM 88201-7767
(575) 489-4750
(575) 586-4414
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
12/31/2019
Last updated
01/08/2020
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