Provider Demographics
NPI:1013784446
Name:MENTAL FLEX LLC
Entity type:Organization
Organization Name:MENTAL FLEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEEKEN
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:732-492-8976
Mailing Address - Street 1:154 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3608
Mailing Address - Country:US
Mailing Address - Phone:732-860-8732
Mailing Address - Fax:
Practice Address - Street 1:154 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07095-3608
Practice Address - Country:US
Practice Address - Phone:732-860-8732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1275272486Medicaid