Provider Demographics
NPI:1669264198
Name:ENDURA PSYCHIATRIC SERVICES LLC
Entity type:Organization
Organization Name:ENDURA PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/ NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDES
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:636-402-9499
Mailing Address - Street 1:2480 EXECUTIVE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5608
Mailing Address - Country:US
Mailing Address - Phone:636-402-9949
Mailing Address - Fax:636-206-8634
Practice Address - Street 1:2480 EXECUTIVE DR STE 200
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5608
Practice Address - Country:US
Practice Address - Phone:636-402-9949
Practice Address - Fax:636-206-8634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty