New Mexico Wellness Center Llc | |
4111 Barbara Loop Se Ste E1 Rio Rancho NM 87124-1068 | |
(505) 715-9587 | |
(505) 792-7982 |
Full Name | New Mexico Wellness Center Llc |
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Speciality | Counselor |
Location | 4111 Barbara Loop Se Ste E1, Rio Rancho, New Mexico |
Authorized Official Name and Position | Stefanie Juliano (OWNER) |
Authorized Official Contact | 5057159587 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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New Mexico Wellness Center Llc 2737 Bayas Rd Se Rio Rancho NM 87124-2971 Ph: (505) 715-9587 | New Mexico Wellness Center Llc 4111 Barbara Loop Se Ste E1 Rio Rancho NM 87124-1068 Ph: (505) 715-9587 |
NPI Number | 1467083956 |
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Provider Enumeration Date | 02/03/2020 |
Last Update Date | 02/03/2020 |
Certification Date | 02/03/2020 |
Medicare PECOS PAC ID | 7214340819 |
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Medicare Enrollment ID | O20201228001189 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467083956 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Provider Name | Deidra Marie Cordova |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1851806525 PECOS PAC ID: 1355753385 Enrollment ID: I20201216002722 |
Provider Name | Aaron David Schwartz |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1861733156 PECOS PAC ID: 7719127067 Enrollment ID: I20220527001354 |
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