Healthcare Provider Details

I. General information

NPI: 1215106471
Provider Name (Legal Business Name): UKEP-MONTWOOD CAMPUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11150 MONTWOOD DR BUILDING A
EL PASO TX
79936-4240
US

IV. Provider business mailing address

11150 MONTWOOD DR BUILDING A
EL PASO TX
79936-4240
US

V. Phone/Fax

Practice location:
  • Phone: 915-591-2101
  • Fax: 915-591-2113
Mailing address:
  • Phone: 915-591-2101
  • Fax: 915-591-2113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIA LOURDES LUNA
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 915-591-2101