| Livingwell | |
|
312 Wayne Rd Nw Los Ranchos NM 87114-1028 | |
| (505) 792-4519 | |
| Not Available |
| Full Name | Livingwell |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 312 Wayne Rd Nw, Los Ranchos, New Mexico |
| Authorized Official Name and Position | Daniel Mintie (OWNER) |
| Authorized Official Contact | 5057924519 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Livingwell 312 Wayne Rd Nw Los Ranchos NM 87114-1028 Ph: () - | Livingwell 312 Wayne Rd Nw Los Ranchos NM 87114-1028 Ph: (505) 792-4519 |
| NPI Number | 1073800702 |
|---|---|
| Provider Enumeration Date | 07/01/2011 |
| Last Update Date | 07/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073800702 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-06493 (New Mexico) | Primary |
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