| Mended House Counseling | |
|
3916 Augusta Dr Se Rio Rancho NM 87124-8246 | |
| (505) 903-9510 | |
| Not Available |
| Full Name | Mended House Counseling |
|---|---|
| Speciality | Counselor |
| Location | 3916 Augusta Dr Se, Rio Rancho, New Mexico |
| Authorized Official Name and Position | Stacey Demarey (PARTNER) |
| Authorized Official Contact | 5059039510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mended House Counseling 3916 Augusta Dr Se Rio Rancho NM 87124-8246 Ph: (505) 903-9510 | Mended House Counseling 3916 Augusta Dr Se Rio Rancho NM 87124-8246 Ph: (505) 903-9510 |
| NPI Number | 1467024992 |
|---|---|
| Provider Enumeration Date | 07/14/2021 |
| Last Update Date | 10/05/2021 |
| Certification Date | 10/05/2021 |
| Medicare PECOS PAC ID | 9638567647 |
|---|---|
| Medicare Enrollment ID | O20211025001682 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467024992 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Stacey Demarey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598160020 PECOS PAC ID: 1456749464 Enrollment ID: I20211025001881 |
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