| Pawsitively Transformational Health And Wellness Inc | |
|
715 Dooley St Alamogordo NM 88310-8203 | |
| (575) 404-1577 | |
| Not Available |
| Full Name | Pawsitively Transformational Health And Wellness Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 715 Dooley St, Alamogordo, New Mexico |
| Authorized Official Name and Position | Nathaniel L Redekopp (CEO) |
| Authorized Official Contact | 5752086364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pawsitively Transformational Health And Wellness Inc 1111 10th St # 400 Alamogordo NM 88310-6413 Ph: () - | Pawsitively Transformational Health And Wellness Inc 715 Dooley St Alamogordo NM 88310-8203 Ph: (575) 404-1577 |
| NPI Number | 1316547904 |
|---|---|
| Provider Enumeration Date | 11/01/2020 |
| Last Update Date | 02/07/2023 |
| Certification Date | 02/07/2023 |
| Medicare PECOS PAC ID | 1658769799 |
|---|---|
| Medicare Enrollment ID | O20211022001213 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316547904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jeanette C Borunda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821444290 PECOS PAC ID: 6709274871 Enrollment ID: I20211022001417 |
| Provider Name | Nathaniel L Redekopp |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952921223 PECOS PAC ID: 3173911211 Enrollment ID: I20240227003787 |
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