Provider Demographics
NPI:1396276507
Name:CARITAS MENTAL HEALTH LLC
Entity type:Organization
Organization Name:CARITAS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BALBINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENGU
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:775-846-5986
Mailing Address - Street 1:2696 BERTINI CT
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-2046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2696 BERTINI CT
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-2046
Practice Address - Country:US
Practice Address - Phone:775-846-5986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty