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1900 Westridge Rd Carlsbad NM 88220-3550 | |
| (575) 725-5552 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1900 Westridge Rd, Carlsbad, New Mexico |
| Authorized Official Name and Position | Kimberly Susan Rogge-rogers (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5753028304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 3141 Carlsbad NM 88221-3141 Ph: (575) 302-8304 | 1900 Westridge Rd Carlsbad NM 88220-3550 Ph: (575) 725-5552 |
| NPI Number | 1467047977 |
|---|---|
| Provider Enumeration Date | 03/05/2021 |
| Last Update Date | 12/30/2022 |
| Certification Date | 12/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467047977 | NPI | - | NPPES |
| 2492137 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
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