| Mental Health Wellness Center Llc | |
|
3855 Foothills Rd Ste C Las Cruces NM 88011 | |
| (575) 520-2861 | |
| (575) 652-4937 |
| Full Name | Mental Health Wellness Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3855 Foothills Rd Ste C, Las Cruces, New Mexico |
| Authorized Official Name and Position | Bill Lafreniere (CREDENTIALING MANAGER) |
| Authorized Official Contact | 5755321888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Wellness Center Llc 3855 Foothills Rd Ste C Las Cruces NM 88011-4772 Ph: (575) 520-2861 | Mental Health Wellness Center Llc 3855 Foothills Rd Ste C Las Cruces NM 88011 Ph: (575) 520-2861 |
| NPI Number | 1457898348 |
|---|---|
| Provider Enumeration Date | 01/30/2017 |
| Last Update Date | 01/15/2020 |
| Certification Date | 01/15/2020 |
| Medicare PECOS PAC ID | 8224315379 |
|---|---|
| Medicare Enrollment ID | O20170427002090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457898348 | NPI | - | NPPES |
| 53627580 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jennelle D Hindash |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033247275 PECOS PAC ID: 3577698141 Enrollment ID: I20100322000247 |
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