Healthcare Provider Details

I. General information

NPI: 1952233579
Provider Name (Legal Business Name): MENM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 GRAND CENTRAL AVE STE 119
VIENNA WV
26105-1079
US

IV. Provider business mailing address

8300 CENTRAL PARK DR STE 100
WACO TX
76712-6666
US

V. Phone/Fax

Practice location:
  • Phone: 304-973-1632
  • Fax:
Mailing address:
  • Phone: 254-227-6825
  • Fax: 254-300-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: DANA STEM
Title or Position: ACCOUNTING SUPERVISOR
Credential:
Phone: 254-307-3512