| The Oak Bower, Llc | |
|
1201 Eubank Blvd Ne Ste 1 Albuquerque NM 87112 | |
| (505) 503-1959 | |
| (505) 369-1851 |
| Full Name | The Oak Bower, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1201 Eubank Blvd Ne Ste 1, Albuquerque, New Mexico |
| Authorized Official Name and Position | Amber Deon Mceachern (CLINICAL PSYCHOLOGIST, OWNER) |
| Authorized Official Contact | 5055031959 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Oak Bower, Llc 1201 Eubank Blvd Ne Ste 1 Albuquerque NM 87112-5300 Ph: (505) 503-1959 | The Oak Bower, Llc 1201 Eubank Blvd Ne Ste 1 Albuquerque NM 87112 Ph: (505) 503-1959 |
| NPI Number | 1679072672 |
|---|---|
| Provider Enumeration Date | 02/05/2018 |
| Last Update Date | 06/19/2018 |
| Medicare PECOS PAC ID | 5092061408 |
|---|---|
| Medicare Enrollment ID | O20180627001168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679072672 | NPI | - | NPPES |
| 58883304 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amber Deon Mceachern |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497784292 PECOS PAC ID: 6901152313 Enrollment ID: I20180627001496 |
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