| Centro Savila | |
|
1317 Isleta Blvd Sw Albuquerque NM 87105-4035 | |
| (505) 312-7296 | |
| Not Available |
| Full Name | Centro Savila |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1317 Isleta Blvd Sw, Albuquerque, New Mexico |
| Authorized Official Name and Position | William G Wagner (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5056041640 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Savila 1317 Isleta Blvd Sw Albuquerque NM 87105-4035 Ph: (505) 312-7296 | Centro Savila 1317 Isleta Blvd Sw Albuquerque NM 87105-4035 Ph: (505) 312-7296 |
| NPI Number | 1154678639 |
|---|---|
| Provider Enumeration Date | 08/14/2012 |
| Last Update Date | 07/29/2013 |
| Medicare PECOS PAC ID | 1456588391 |
|---|---|
| Medicare Enrollment ID | O20131220000626 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154678639 | NPI | - | NPPES |
| 39100201 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | I-3886 (New Mexico) | Primary |
| Provider Name | William G Wagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730265042 PECOS PAC ID: 4082666896 Enrollment ID: I20050219000012 |
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