| Jade Therapy, Llc | |
|
1505 15th St Ste C Los Alamos NM 87544-3000 | |
| (505) 692-9513 | |
| Not Available |
| Full Name | Jade Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1505 15th St Ste C, Los Alamos, New Mexico |
| Authorized Official Name and Position | Claire Julia Wood (PARTNER) |
| Authorized Official Contact | 5056929513 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jade Therapy, Llc 1006 Paseo De La Cuma Santa Fe NM 87501-1221 Ph: (505) 692-9513 | Jade Therapy, Llc 1505 15th St Ste C Los Alamos NM 87544-3000 Ph: (505) 692-9513 |
| NPI Number | 1922519735 |
|---|---|
| Provider Enumeration Date | 10/19/2017 |
| Last Update Date | 08/19/2021 |
| Certification Date | 08/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922519735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 0189841 (New Mexico) | Primary |
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