Provider Demographics
NPI:1205303781
Name:MENTAL HEALTH CONNECTION, INC
Entity type:Organization
Organization Name:MENTAL HEALTH CONNECTION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-493-2593
Mailing Address - Street 1:5096 MIDDLETON PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-1406
Mailing Address - Country:US
Mailing Address - Phone:787-704-9733
Mailing Address - Fax:
Practice Address - Street 1:8501 SW 124TH AVE STE 312
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4634
Practice Address - Country:US
Practice Address - Phone:713-493-2593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-01
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty