| Amistad Y Resolana | |
|
713 Railroad Ave Las Vegas NM 87701-4532 | |
| (505) 617-5846 | |
| (505) 454-7198 |
| Full Name | Amistad Y Resolana |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 713 Railroad Ave, Las Vegas, New Mexico |
| Authorized Official Name and Position | Alejandro J Rivera (DIRECTOR) |
| Authorized Official Contact | 5056175846 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amistad Y Resolana 713 Railroad Ave Las Vegas NM 87701-4532 Ph: (505) 617-5846 | Amistad Y Resolana 713 Railroad Ave Las Vegas NM 87701-4532 Ph: (505) 617-5846 |
| NPI Number | 1063844363 |
|---|---|
| Provider Enumeration Date | 08/08/2013 |
| Last Update Date | 08/08/2013 |
| Medicare PECOS PAC ID | 1951707561 |
|---|---|
| Medicare Enrollment ID | O20210907003630 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063844363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 3730 (New Mexico) | Primary |
| Provider Name | Lydia Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871933721 PECOS PAC ID: 4981939550 Enrollment ID: I20190718002443 |
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