Provider Demographics
NPI:1700506532
Name:ALERT MIND MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:ALERT MIND MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:EXILUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-722-4740
Mailing Address - Street 1:1423 CAPITOL TRL STE 1110
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5709
Mailing Address - Country:US
Mailing Address - Phone:302-722-4740
Mailing Address - Fax:302-722-4750
Practice Address - Street 1:1423 CAPITOL TRL STE 1110
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5709
Practice Address - Country:US
Practice Address - Phone:302-722-4740
Practice Address - Fax:302-722-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty