| Guadalupe Psychiatric And Mental Health Services | |
|
1005 21st St Se Ste 7 Rio Rancho NM 87124-4030 | |
| (505) 459-6101 | |
| Not Available |
| Full Name | Guadalupe Psychiatric And Mental Health Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1005 21st St Se, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Yvonne D Hall (SOLE OWNER) |
| Authorized Official Contact | 5054596101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guadalupe Psychiatric And Mental Health Services 2003 Southern Blvd Se Ste 102-214 Rio Rancho NM 87124-3751 Ph: (505) 459-6101 | Guadalupe Psychiatric And Mental Health Services 1005 21st St Se Ste 7 Rio Rancho NM 87124-4030 Ph: (505) 459-6101 |
| NPI Number | 1699091389 |
|---|---|
| Provider Enumeration Date | 04/20/2010 |
| Last Update Date | 07/21/2010 |
| Medicare PECOS PAC ID | 5496934291 |
|---|---|
| Medicare Enrollment ID | O20110126000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699091389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 20030591 (New Mexico) | Primary |
| Provider Name | Yvonne D Hall |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1922029164 PECOS PAC ID: 8527968502 Enrollment ID: I20040113000734 |
| Provider Name | Jimmy M Calzado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003162736 PECOS PAC ID: 0547405854 Enrollment ID: I20130314000086 |
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