| House Of The Sacred Journey Inc | |
|
1920 7th St Las Vegas NM 87701-4956 | |
| (505) 429-3980 | |
| Not Available |
| Full Name | House Of The Sacred Journey Inc |
|---|---|
| Speciality | Counselor |
| Location | 1920 7th St, Las Vegas, New Mexico |
| Authorized Official Name and Position | Patricia D Rodriguez (PRESIDENT) |
| Authorized Official Contact | 5054293980 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| House Of The Sacred Journey Inc 1920 7th St Las Vegas NM 87701-4956 Ph: (505) 429-3980 | House Of The Sacred Journey Inc 1920 7th St Las Vegas NM 87701-4956 Ph: (505) 429-3980 |
| NPI Number | 1730792698 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/09/2025 |
| Medicare PECOS PAC ID | 4486189594 |
|---|---|
| Medicare Enrollment ID | O20241126004158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730792698 | NPI | - | NPPES |
| Provider Name | Patricia Dolores Rodriguez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699912055 PECOS PAC ID: 4082012000 Enrollment ID: I20241126004441 |
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