| Take Action Llc | |
|
704 Central Avenue West Suite B Moriarty NM 87035 | |
| (505) 901-9143 | |
| Not Available |
| Full Name | Take Action Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 704 Central Avenue West Suite B, Moriarty, New Mexico |
| Authorized Official Name and Position | Melissa A Nandino (THERAPIST) |
| Authorized Official Contact | 5058329135 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Take Action Llc Po Box 85 704 Us Rt 66 Suite B Moriarty NM 87035-0085 Ph: (505) 832-9135 | Take Action Llc 704 Central Avenue West Suite B Moriarty NM 87035 Ph: (505) 901-9143 |
| NPI Number | 1558808634 |
|---|---|
| Provider Enumeration Date | 01/26/2017 |
| Last Update Date | 05/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558808634 | NPI | - | NPPES |
| 51305887 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0118471 (New Mexico) | Primary |
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