| All Faiths | |
|
1709 Moon St Ne Albuquerque NM 87112-3935 | |
| (505) 271-0329 | |
| (505) 271-4957 |
| Full Name | All Faiths |
|---|---|
| Speciality | Clinic/Center |
| Location | 1709 Moon St Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Krisztina Ford (CEO/PRESIDENT) |
| Authorized Official Contact | 5052710329 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| All Faiths 1709 Moon St Ne Albuquerque NM 87112-3935 Ph: (505) 271-0329 | All Faiths 1709 Moon St Ne Albuquerque NM 87112-3935 Ph: (505) 271-0329 |
| NPI Number | 1093935959 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 07/28/2016 |
| Medicare PECOS PAC ID | 9537517149 |
|---|---|
| Medicare Enrollment ID | O20231120003542 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093935959 | NPI | - | NPPES |
| 65224086 | Medicaid | NM | |
| M1099 | Medicaid | NM | |
| NM600027 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | M1099 (New Mexico) | Secondary |
| 261QR0800X | Clinic/center - Recovery Care | M1099 (New Mexico) | Primary |
| Provider Name | Isidro Vigil |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548677818 PECOS PAC ID: 1850749466 Enrollment ID: I20231120003685 |
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