MEDICARE: EL PASO COMMUNITY MHMR

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	101011	TX
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	261QM2800X	Methadone Clinic
4	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
5	261QM1300X	Multi-Specialty Clinic/Center

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1649345869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL PASO COMMUNITY MHMR

Provider Business Mailing Address
First Line	:	201 E. MAIN ST.
Second Line	:	SUITE 600
City	:	EL PASO
State	:	TX
Zip	:	79901-1385
Country	:	US
Telephone Number	:	915-887-3410
Fax Number	:	915-351-4708

Provider Business Practice Location Address
First Line	:	1600 MONTANA AVE.
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902-5622
Country	:	US
Telephone Number	:	915-887-3410
Fax Number	:	915-351-3643

Authorized Official
Title or Position	:	CHIEF OF REVENUE CYCLE
Name	:	MICHELLE SUZANNE APONTE-PACHECO
Credential	:	MBA, MSW
Telephone Number	:	915-887-3410

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/12/2025

1600 MONTANA AVE # 205 , 201 E. MAIN ST EL PASO TEXAS 79901
EL PASO, TX
79902-5622

Practice Phone: 915-747-3510
Practice Fax: