| Mental Health Stop Llc | |
|
1096 Mechem Dr Ste 213 Ruidoso NM 88345-7068 | |
| (575) 223-8184 | |
| Not Available |
| Full Name | Mental Health Stop Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1096 Mechem Dr Ste 213, Ruidoso, New Mexico |
| Authorized Official Name and Position | Mari Lynn Scarlett Gutierrez (REGISTERED AGENT & CO-OWNER) |
| Authorized Official Contact | 5752238184 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Stop Llc 1096 Mechem Dr Ste 213 Ruidoso NM 88345-7068 Ph: (575) 223-8184 | Mental Health Stop Llc 1096 Mechem Dr Ste 213 Ruidoso NM 88345-7068 Ph: (575) 223-8184 |
| NPI Number | 1760032577 |
|---|---|
| Provider Enumeration Date | 09/13/2019 |
| Last Update Date | 12/09/2019 |
| Certification Date | 12/09/2019 |
| Medicare PECOS PAC ID | 9032440474 |
|---|---|
| Medicare Enrollment ID | O20191016000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760032577 | NPI | - | NPPES |
| Provider Name | Mari Lynn Scarlett Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831501147 PECOS PAC ID: 1850622291 Enrollment ID: I20191016000319 |
| Provider Name | Erique Emmanuel Gutierrez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376858241 PECOS PAC ID: 2769713106 Enrollment ID: I20210728002044 |
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