| A Place Of Healing Llc | |
|
121 Wyatt Dr Ste 5 Las Cruces NM 88005-2960 | |
| (575) 644-9209 | |
| (575) 647-5050 |
| Full Name | A Place Of Healing Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 121 Wyatt Dr Ste 5, Las Cruces, New Mexico |
| Authorized Official Name and Position | Amy Lyn Trevino (PROVIDER/OPERATOR) |
| Authorized Official Contact | 57546449209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Place Of Healing Llc 5065 Comanche Trl Las Cruces NM 88012-7376 Ph: (575) 644-9209 | A Place Of Healing Llc 121 Wyatt Dr Ste 5 Las Cruces NM 88005-2960 Ph: (575) 644-9209 |
| NPI Number | 1912316308 |
|---|---|
| Provider Enumeration Date | 08/11/2014 |
| Last Update Date | 08/11/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912316308 | NPI | - | NPPES |
| 04932862 | Medicaid | NM | |
| 1477626299 | Other | NM | INDIVIDUAL NPI# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0116921 (New Mexico) | Primary |
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