| Breaking Boxes | |
|
606 Ivy St Truth Or Consequences NM 87901-1634 | |
| (575) 297-4039 | |
| (575) 297-4039 |
| Full Name | Breaking Boxes |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 606 Ivy St, Truth Or Consequences, New Mexico |
| Authorized Official Name and Position | Penni Lane Sears (CEO) |
| Authorized Official Contact | 5752974039 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Breaking Boxes 606 Ivy St Truth Or Consequences NM 87901-1634 Ph: (575) 297-4039 | Breaking Boxes 606 Ivy St Truth Or Consequences NM 87901-1634 Ph: (575) 297-4039 |
| NPI Number | 1174863419 |
|---|---|
| Provider Enumeration Date | 02/23/2013 |
| Last Update Date | 01/20/2022 |
| Certification Date | 01/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174863419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (New Mexico) | Primary |
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