| |
102 E High St Tucumcari NM 88401-2726 | |
(505) 461-6200 | |
(505) 461-0404 |
Full Name | |
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Speciality | Counselor |
Location | 102 E High St, Tucumcari, New Mexico |
Authorized Official Name and Position | Dave L. Crane (OWNER/OPERATOR) |
Authorized Official Contact | 5754616200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 881 Tucumcari NM 88401-0881 Ph: (575) 461-6200 | 102 E High St Tucumcari NM 88401-2726 Ph: (505) 461-6200 |
NPI Number | 1518180777 |
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Provider Enumeration Date | 04/10/2007 |
Last Update Date | 06/12/2024 |
Medicare PECOS PAC ID | 1355883851 |
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Medicare Enrollment ID | O20240612002416 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518180777 | NPI | - | NPPES |
43220380 | Medicaid | NM | |
90701801 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 006177 (New Mexico) | Primary |
Provider Name | David L Crane |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1871568410 PECOS PAC ID: 4082156583 Enrollment ID: I20240702001463 |
New Day Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 706 S 1st St Ste 112, Tucumcari, NM 88401 Phone: 575-403-7631 | |
Huffman Counseling And Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 108 W Center St, Tucumcari, NM 88401 Phone: 575-403-6114 | |