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1200 Thornton St Ste A Clovis NM 88101-5508 | |
| (575) 763-4400 | |
| (575) 935-0400 |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1200 Thornton St Ste A, Clovis, New Mexico |
| Authorized Official Name and Position | Steve Reshetar (DIRECTOR) |
| Authorized Official Contact | 5757634400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1200 Thornton St Ste A Clovis NM 88101-5508 Ph: (575) 763-4400 | 1200 Thornton St Ste A Clovis NM 88101-5508 Ph: (575) 763-4400 |
| NPI Number | 1609001684 |
|---|---|
| Provider Enumeration Date | 05/20/2009 |
| Last Update Date | 05/08/2021 |
| Certification Date | 05/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609001684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0153271 (New Mexico) | Primary |
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