On Wings Like Eagles, Llc | |
1445 Pecos Las Cruces NM 88005 | |
(575) 650-0071 | |
Not Available |
Full Name | On Wings Like Eagles, Llc |
---|---|
Speciality | Counselor - Professional |
Location | 1445 Pecos, Las Cruces, New Mexico |
Authorized Official Name and Position | Edward G Kruis (OWNER) |
Authorized Official Contact | 5756500071 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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On Wings Like Eagles, Llc 1801 Las Tunas Dr Las Cruces NM 88011-4956 Ph: (575) 650-0071 | On Wings Like Eagles, Llc 1445 Pecos Las Cruces NM 88005 Ph: (575) 650-0071 |
NPI Number | 1245403807 |
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Provider Enumeration Date | 04/03/2008 |
Last Update Date | 04/03/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245403807 | NPI | - | NPPES |
94876860 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 0106801 (New Mexico) | Secondary |
101YP2500X | Counselor - Professional | 0078221 (New Mexico) | Primary |
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