Organization Active NPI

Monte Nido Texas, LLC

Doing business as Clementine Houston

  • Adolescent and Children Mental Health Clinic/Center
  • Conroe, TX
National Provider Identifier
1245704915
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
MONTE NIDO TEXAS, LLC
Doing business as
Clementine Houston
Practice address
15252 Saddlewood Dr
Conroe, TX 77384-3453
Phone
(305) 663-1876
Fax
(914) 479-5490
NPI assigned
Jan 16, 2019
Last updated
Apr 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mike Bagley
Title
Chief Financial Officer
Phone
(305) 663-1876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU Primary

Addresses

Primary practice location

15252 Saddlewood Dr
Conroe, TX 77384-3453

Mailing address

6100 SW 76TH St
South Miami, FL 33143-5002
Phone (305) 663-1876

Other names 1

  • Clementine Houston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clementine Houston3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1245704915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 SW 76TH ST",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331435002",
            "telephone_number": "305-663-1876",
            "fax_number": "914-479-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15252 SADDLEWOOD DR",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773843453",
            "telephone_number": "305-663-1876",
            "fax_number": "914-479-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTE NIDO TEXAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-16",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "BAGLEY",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "305-663-1876",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clementine Houston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.