Provider Demographics
NPI:1285479758
Name:MENTAL EASE LLC
Entity type:Organization
Organization Name:MENTAL EASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:NERILENE
Authorized Official - Middle Name:LEENA
Authorized Official - Last Name:BALLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:754-280-0137
Mailing Address - Street 1:11411 SW 45TH MNR UNIT 203
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7909
Mailing Address - Country:US
Mailing Address - Phone:754-280-0137
Mailing Address - Fax:
Practice Address - Street 1:7971 RIVIERA BLVD STE 314
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6448
Practice Address - Country:US
Practice Address - Phone:754-280-0137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty