| Excelsior Mental Health Services | |
|
1705 N Valley Dr Ste 12 Las Cruces NM 88007-5121 | |
| (575) 642-5544 | |
| Not Available |
| Full Name | Excelsior Mental Health Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1705 N Valley Dr Ste 12, Las Cruces, New Mexico |
| Authorized Official Name and Position | Jason Wyatt (OWNER/THERAPIST) |
| Authorized Official Contact | 5756425544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Excelsior Mental Health Services Po Box 375 Fairacres NM 88033-0375 Ph: () - | Excelsior Mental Health Services 1705 N Valley Dr Ste 12 Las Cruces NM 88007-5121 Ph: (575) 642-5544 |
| NPI Number | 1336718287 |
|---|---|
| Provider Enumeration Date | 06/23/2021 |
| Last Update Date | 09/07/2021 |
| Certification Date | 09/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336718287 | NPI | - | NPPES |
| 61121282 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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