=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124159447
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EL PASO COMMUNITY MHMR
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8730 BOEING DR.
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79925-1224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-887-3410
-----------------------------------------------------
Fax | 915-351-3643
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 201 E. MAIN ST. SUITE 600
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79901-1385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-887-3410
-----------------------------------------------------
Fax | 915-351-4708
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OF REVENUE CYCLE
-----------------------------------------------------
Name | MICHELLE SUZANNE APONTE-PACHECO
-----------------------------------------------------
Credential | MBA, MSW
-----------------------------------------------------
Telephone | 915-887-3410
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 101011
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------