| Open House Llc | |
|
1119 Douglas Ave Las Vegas NM 87701-3932 | |
| (505) 718-6930 | |
| (505) 454-3803 |
| Full Name | Open House Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1119 Douglas Ave, Las Vegas, New Mexico |
| Authorized Official Name and Position | Deborah A. Reumann (MANAGING DIRECTOR) |
| Authorized Official Contact | 5057186930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open House Llc 1119 Douglas Ave Las Vegas NM 87701-3932 Ph: (505) 718-6930 | Open House Llc 1119 Douglas Ave Las Vegas NM 87701-3932 Ph: (505) 718-6930 |
| NPI Number | 1831275536 |
|---|---|
| Provider Enumeration Date | 10/27/2006 |
| Last Update Date | 02/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831275536 | NPI | - | NPPES |
| 000G1676 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | I-4116 (New Mexico) | Primary |
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