| Boldly Resilient LLC | |
|
6713 4th St Nw Los Ranchos NM 87107-6114 | |
| (505) 718-2119 | |
| Not Available |
| Full Name | Boldly Resilient LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6713 4th St Nw, Los Ranchos, New Mexico |
| Authorized Official Name and Position | Dolores Ruiz-chavez (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5057182119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boldly Resilient LLC 6411 Canavio Pl Nw Albuquerque NM 87120-7052 Ph: (505) 718-2119 | Boldly Resilient LLC 6713 4th St Nw Los Ranchos NM 87107-6114 Ph: (505) 718-2119 |
| NPI Number | 1518752534 |
|---|---|
| Provider Enumeration Date | 04/10/2025 |
| Last Update Date | 05/14/2026 |
| Certification Date | 05/14/2026 |
| Medicare PECOS PAC ID | 5991201758 |
|---|---|
| Medicare Enrollment ID | O20251001000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518752534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Dolores Ruiz-chavez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124740287 PECOS PAC ID: 5799281556 Enrollment ID: I20251001000233 |
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