| Tribalights Inc | |
|
20 Road 2050 Aztec NM 87410-3004 | |
| (310) 721-4398 | |
| Not Available |
| Full Name | Tribalights Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 20 Road 2050, Aztec, New Mexico |
| Authorized Official Name and Position | Phoenix Germano (CO-FOUNDER & COO) |
| Authorized Official Contact | 3107214398 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tribalights Inc 20548 Ventura Blvd # 10-407 Woodland Hills CA 91364-6225 Ph: (310) 721-4398 | Tribalights Inc 20 Road 2050 Aztec NM 87410-3004 Ph: (310) 721-4398 |
| NPI Number | 1063296820 |
|---|---|
| Provider Enumeration Date | 08/22/2023 |
| Last Update Date | 08/23/2023 |
| Certification Date | 08/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063296820 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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