| Duke City Mind Institute Llc | |
|
5724 Osuna Rd Ne Albuquerque NM 87109-2527 | |
| (505) 377-5435 | |
| (505) 672-7769 |
| Full Name | Duke City Mind Institute Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5724 Osuna Rd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Elizabeth Hadsell (OWNER) |
| Authorized Official Contact | 5053775435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duke City Mind Institute Llc Po Box 46581 Rio Rancho NM 87174-6581 Ph: (505) 226-1960 | Duke City Mind Institute Llc 5724 Osuna Rd Ne Albuquerque NM 87109-2527 Ph: (505) 377-5435 |
| NPI Number | 1245994797 |
|---|---|
| Provider Enumeration Date | 10/29/2021 |
| Last Update Date | 06/22/2022 |
| Certification Date | 06/22/2022 |
| Medicare PECOS PAC ID | 2769877638 |
|---|---|
| Medicare Enrollment ID | O20220314000001 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245994797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Hadsell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235892720 PECOS PAC ID: 3678968542 Enrollment ID: I20220314000007 |
| Provider Name | Tara Kasten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265187371 PECOS PAC ID: 8527446830 Enrollment ID: I20220527000351 |
| Provider Name | Erica Denise Ortiz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659971919 PECOS PAC ID: 4789062845 Enrollment ID: I20220601001063 |
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