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General NPI Number Information
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NPI Number | 1083252902
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Entity Type | Organization
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Legal Business Name | MORE 2 LIFE MENTAL HEALTH LLC
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Dates
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Enumeration Date | 12/11/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 11811 NORTH FWY STE 555
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City | HOUSTON
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State | TX
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Zip | 77060-3245
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Country | US
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Telephone | 804-549-6576
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Fax |
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Provider Business Mailing Address
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Address Line | 11811 NORTH FWY STE 555
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City | HOUSTON
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State | TX
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Zip | 77060-3245
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Country | US
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Telephone | 804-549-6576
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Fax |
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Authorized Official
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Title or Position | PROGRAM MANAGER
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Name | MR. DEONTE LYNELL MONTERIA
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Credential |
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Telephone | 804-549-6576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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