| Skye Mesa Llc | |
|
5 Warm Creek Rd San Lorenzo NM 88041-9536 | |
| (505) 303-0726 | |
| Not Available |
| Full Name | Skye Mesa Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 5 Warm Creek Rd, San Lorenzo, New Mexico |
| Authorized Official Name and Position | Eliza Skye (OWNER) |
| Authorized Official Contact | 5053030726 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Skye Mesa Llc 5 Warm Creek Rd San Lorenzo NM 88041-9536 Ph: (505) 303-0726 | Skye Mesa Llc 5 Warm Creek Rd San Lorenzo NM 88041-9536 Ph: (505) 303-0726 |
| NPI Number | 1790471076 |
|---|---|
| Provider Enumeration Date | 04/11/2023 |
| Last Update Date | 04/11/2023 |
| Certification Date | 04/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790471076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |