| Coaches Korner & The Empowerment Center Of New Mexico Llc | |
|
901 Indiana St Se Albuquerque NM 87108-4903 | |
| (505) 203-6164 | |
| Not Available |
| Full Name | Coaches Korner & The Empowerment Center Of New Mexico Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 901 Indiana St Se, Albuquerque, New Mexico |
| Authorized Official Name and Position | Gregory Aydren Mcneil (OWNER) |
| Authorized Official Contact | 5052036164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coaches Korner & The Empowerment Center Of New Mexico Llc 5555 Zuni Rd Se Ste 20-277 Albuquerque NM 87108-2942 Ph: (505) 203-6164 | Coaches Korner & The Empowerment Center Of New Mexico Llc 901 Indiana St Se Albuquerque NM 87108-4903 Ph: (505) 203-6164 |
| NPI Number | 1841493491 |
|---|---|
| Provider Enumeration Date | 06/08/2007 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841493491 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0103731 (New Mexico) | Primary |
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