| Grace Integrated Solutions, Llc | |
|
4604 Snapdragon Rd Nw Albuquerque NM 87120-2752 | |
| (505) 944-6991 | |
| Not Available |
| Full Name | Grace Integrated Solutions, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4604 Snapdragon Rd Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Martha Medina (CLIN ICAL DIRECTOR) |
| Authorized Official Contact | 5059446991 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Integrated Solutions, Llc 4604 Snapdragon Rd Nw Albuquerque NM 87120-2752 Ph: (505) 944-6991 | Grace Integrated Solutions, Llc 4604 Snapdragon Rd Nw Albuquerque NM 87120-2752 Ph: (505) 944-6991 |
| NPI Number | 1477208015 |
|---|---|
| Provider Enumeration Date | 02/11/2022 |
| Last Update Date | 02/11/2022 |
| Certification Date | 02/11/2022 |
| Medicare PECOS PAC ID | 3971959156 |
|---|---|
| Medicare Enrollment ID | O20231024002558 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477208015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Martha Medina |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497328900 PECOS PAC ID: 4587660675 Enrollment ID: I20231024002624 |
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