Healthcare Provider Details

I. General information

NPI: 1548097793
Provider Name (Legal Business Name): DEER OAKS BEHAVIORAL HEALTH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 TERRACE DR
LAS CRUCES NM
88011-5053
US

IV. Provider business mailing address

7272 WURZBACH RD STE 601
SAN ANTONIO TX
78240-4803
US

V. Phone/Fax

Practice location:
  • Phone: 210-615-3472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK NEESE JR.
Title or Position: CFO
Credential:
Phone: 210-615-3434