| Embrace, Inc. | |
|
1717 W 2nd St Ste 116 Roswell NM 88201-2027 | |
| (575) 840-1075 | |
| Not Available |
| Full Name | Embrace, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1717 W 2nd St Ste 116, Roswell, New Mexico |
| Authorized Official Name and Position | Nathan Matthew Padilla (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5758401075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Embrace, Inc. Po Box 4425 Roswell NM 88202-4425 Ph: (575) 840-1075 | Embrace, Inc. 1717 W 2nd St Ste 116 Roswell NM 88201-2027 Ph: (575) 840-1075 |
| NPI Number | 1265761449 |
|---|---|
| Provider Enumeration Date | 12/16/2009 |
| Last Update Date | 10/25/2022 |
| Certification Date | 10/25/2022 |
| Medicare PECOS PAC ID | 4688945108 |
|---|---|
| Medicare Enrollment ID | O20170802001064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265761449 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C-09926 (New Mexico) | Primary |
| Provider Name | Michael A Fraga |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518938315 PECOS PAC ID: 2365527744 Enrollment ID: I20080527000352 |
| Provider Name | Nathan Padilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801129184 PECOS PAC ID: 8123396207 Enrollment ID: I20170802001190 |
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