| Cottonwood Therapeutics Llc | |
|
2900 Louisiana Blvd Ne Ste H Albuquerque NM 87110-3565 | |
| (505) 459-1260 | |
| Not Available |
| Full Name | Cottonwood Therapeutics Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2900 Louisiana Blvd Ne Ste H, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jonathan R. Willoughby (LCSW, OWNER) |
| Authorized Official Contact | 5054591260 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cottonwood Therapeutics Llc 1800 Georgia St Ne Albuquerque NM 87110-5903 Ph: (505) 459-1260 | Cottonwood Therapeutics Llc 2900 Louisiana Blvd Ne Ste H Albuquerque NM 87110-3565 Ph: (505) 459-1260 |
| NPI Number | 1003494303 |
|---|---|
| Provider Enumeration Date | 03/30/2021 |
| Last Update Date | 11/29/2024 |
| Certification Date | 11/29/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003494303 | NPI | - | NPPES |
| 11401346 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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