| Whiteowl Services, Inc. | |
|
3300 Vista Del Sur St Nw Albuquerque NM 87120-1546 | |
| (505) 450-9271 | |
| (505) 873-8489 |
| Full Name | Whiteowl Services, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 3300 Vista Del Sur St Nw, Albuquerque, New Mexico |
| Authorized Official Name and Position | Ina Krieble (PRESIDENT) |
| Authorized Official Contact | 5054509271 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whiteowl Services, Inc. 3300 Vista Del Sur St Nw Albuquerque NM 87120-1546 Ph: (505) 450-9271 | Whiteowl Services, Inc. 3300 Vista Del Sur St Nw Albuquerque NM 87120-1546 Ph: (505) 450-9271 |
| NPI Number | 1063429157 |
|---|---|
| Provider Enumeration Date | 08/02/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1759723414 |
|---|---|
| Medicare Enrollment ID | O20240525000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063429157 | NPI | - | NPPES |
| 89709004 | Medicaid | NM | |
| 37481541 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 006002 (New Mexico) | Primary |
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