| Horizon Healthcare Of New Mexico Inc | |
|
1209 Mountain Road Pl Ne Ste R Albuquerque NM 87110-7845 | |
| (414) 376-5577 | |
| Not Available |
| Full Name | Horizon Healthcare Of New Mexico Inc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1209 Mountain Road Pl Ne Ste R, Albuquerque, New Mexico |
| Authorized Official Name and Position | Karl Rajani (PRESIDENT) |
| Authorized Official Contact | 4145810582 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Horizon Healthcare Of New Mexico Inc 217 Wisconsin Ave Ste 201 Waukesha WI 53186-4946 Ph: (414) 376-5577 | Horizon Healthcare Of New Mexico Inc 1209 Mountain Road Pl Ne Ste R Albuquerque NM 87110-7845 Ph: (414) 376-5577 |
| NPI Number | 1366270670 |
|---|---|
| Provider Enumeration Date | 07/26/2024 |
| Last Update Date | 08/23/2024 |
| Certification Date | 08/23/2024 |
| Medicare PECOS PAC ID | 1456884600 |
|---|---|
| Medicare Enrollment ID | O20241028001407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366270670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Shalonda N Myles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659569929 PECOS PAC ID: 5092143750 Enrollment ID: I20241028001626 |
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