Inner Flame Wellness, Llc | |
525 S Melendres St Las Cruces NM 88005-2805 | |
(575) 636-7117 | |
Not Available |
Full Name | Inner Flame Wellness, Llc |
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Speciality | Social Worker |
Location | 525 S Melendres St, Las Cruces, New Mexico |
Authorized Official Name and Position | Anna Louise Vigil (OWNER/PROVIDER) |
Authorized Official Contact | 5756367117 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Flame Wellness, Llc 111 Cadena St Mesquite NM 88048-9348 Ph: (575) 636-7117 | Inner Flame Wellness, Llc 525 S Melendres St Las Cruces NM 88005-2805 Ph: (575) 636-7117 |
NPI Number | 1184499238 |
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Provider Enumeration Date | 11/20/2023 |
Last Update Date | 11/30/2024 |
Certification Date | 11/30/2024 |
Medicare PECOS PAC ID | 6204376759 |
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Medicare Enrollment ID | O20240911000319 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184499238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Anna Vigil |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1790203479 PECOS PAC ID: 9032506779 Enrollment ID: I20220427000510 |
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