| Mauna Therapy Llc | |
|
2507 N Telshor Blvd Suite A2 Las Cruces NM 88011-8236 | |
| (575) 521-9210 | |
| (575) 521-9201 |
| Full Name | Mauna Therapy Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2507 N Telshor Blvd, Las Cruces, New Mexico |
| Authorized Official Name and Position | Amanda Rose Trout (OWNER) |
| Authorized Official Contact | 5755219210 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mauna Therapy Llc Po Box 14022 Las Cruces NM 88013-4022 Ph: (575) 521-9210 | Mauna Therapy Llc 2507 N Telshor Blvd Suite A2 Las Cruces NM 88011-8236 Ph: (575) 521-9210 |
| NPI Number | 1427286509 |
|---|---|
| Provider Enumeration Date | 06/26/2009 |
| Last Update Date | 06/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427286509 | NPI | - | NPPES |
| 80137857 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | I-06248 (New Mexico) | Primary |
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