Provider Demographics
NPI:1083252902
Name:MORE 2 LIFE MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:MORE 2 LIFE MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEONTE
Authorized Official - Middle Name:LYNELL
Authorized Official - Last Name:MONTERIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-549-6576
Mailing Address - Street 1:11811 NORTH FWY STE 555
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3245
Mailing Address - Country:US
Mailing Address - Phone:804-549-6576
Mailing Address - Fax:
Practice Address - Street 1:11811 NORTH FWY STE 555
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3245
Practice Address - Country:US
Practice Address - Phone:804-549-6576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)