| |
225 E Idaho Ave Ste 30 Las Cruces NM 88005-3242 | |
(575) 635-7832 | |
Not Available |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 225 E Idaho Ave Ste 30, Las Cruces, New Mexico |
Authorized Official Name and Position | Cynthia Ordonez-branco (CLINICAL DIRECTOR) |
Authorized Official Contact | 5756357832 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2314 Las Cruces NM 88004-2314 Ph: (575) 635-7832 | 225 E Idaho Ave Ste 30 Las Cruces NM 88005-3242 Ph: (575) 635-7832 |
NPI Number | 1699448357 |
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Provider Enumeration Date | 07/28/2021 |
Last Update Date | 01/16/2024 |
Certification Date | 01/16/2024 |
Medicare PECOS PAC ID | 6709325921 |
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Medicare Enrollment ID | O20240830002575 |
Identifier | Type | State | Issuer |
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1699448357 | NPI | - | NPPES |
Provider Name | Cynthia Ordonez-branco |
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Provider Type | Practitioner - Marriage And Family Therapist |
Provider Identifiers | NPI Number: 1699261602 PECOS PAC ID: 7517406739 Enrollment ID: I20240830002771 |
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