| Guidance Foundation Inc | |
|
4101 Barbara Loop Se Suite D Rio Rancho NM 87124-1009 | |
| (505) 892-3639 | |
| (505) 892-6348 |
| Full Name | Guidance Foundation Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4101 Barbara Loop Se, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Janice Marion Penn (OWNER) |
| Authorized Official Contact | 5058923639 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guidance Foundation Inc 4101 Barbara Loop Se Suite D Rio Rancho NM 87124-1009 Ph: (505) 892-3639 | Guidance Foundation Inc 4101 Barbara Loop Se Suite D Rio Rancho NM 87124-1009 Ph: (505) 892-3639 |
| NPI Number | 1760421168 |
|---|---|
| Provider Enumeration Date | 06/05/2006 |
| Last Update Date | 08/10/2012 |
| Medicare PECOS PAC ID | 5597760561 |
|---|---|
| Medicare Enrollment ID | O20060926000110 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760421168 | NPI | - | NPPES |
| 98648 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | R14768 (New Mexico) | Primary |
| Provider Name | Janice M Penn |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1144297771 PECOS PAC ID: 1658275854 Enrollment ID: I20031120000352 |
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