Provider Demographics
NPI:1578244646
Name:MENDED MENTAL HEALTH
Entity Type:Organization
Organization Name:MENDED MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/APRN
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:318-228-8635
Mailing Address - Street 1:415 BIENVILLE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5700
Mailing Address - Country:US
Mailing Address - Phone:318-228-8635
Mailing Address - Fax:318-228-8634
Practice Address - Street 1:415 BIENVILLE ST STE 6
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5700
Practice Address - Country:US
Practice Address - Phone:318-228-8635
Practice Address - Fax:318-228-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty