Provider Demographics
NPI:1477125557
Name:LUNA NUEVA MENTAL HEALTH, LLC
Entity Type:Organization
Organization Name:LUNA NUEVA MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEHOYOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-226-5525
Mailing Address - Street 1:2723 CINNAMON TEAL
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-1256
Mailing Address - Country:US
Mailing Address - Phone:512-925-4037
Mailing Address - Fax:
Practice Address - Street 1:102 SUTTLES AVE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5015
Practice Address - Country:US
Practice Address - Phone:830-402-4186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty