Provider Demographics
NPI:1427543776
Name:MEND LLC
Entity Type:Organization
Organization Name:MEND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONDELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-333-5123
Mailing Address - Street 1:2692 W OXFORD LOOP
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5498
Mailing Address - Country:US
Mailing Address - Phone:662-333-5123
Mailing Address - Fax:
Practice Address - Street 1:2692 W OXFORD LOOP
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655
Practice Address - Country:US
Practice Address - Phone:662-822-4657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-28
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1457896979Medicaid