Provider Demographics
NPI:1588318109
Name:MONTERA HEALTH DELAWARE LLC
Entity type:Organization
Organization Name:MONTERA HEALTH DELAWARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-315-6152
Mailing Address - Street 1:8 THE GRN STE A
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3618
Mailing Address - Country:US
Mailing Address - Phone:865-680-1516
Mailing Address - Fax:
Practice Address - Street 1:8 THE GRN STE A
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-3618
Practice Address - Country:US
Practice Address - Phone:865-680-1516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty