| Interweave LLC | |
|
2100 Paseo Ponderosa Santa Fe NM 87501-6319 | |
| (541) 306-8728 | |
| Not Available |
| Full Name | Interweave LLC |
|---|---|
| Speciality | Counselor |
| Location | 2100 Paseo Ponderosa, Santa Fe, New Mexico |
| Authorized Official Name and Position | Lou Duran (CREDENTIALING AND BILLING) |
| Authorized Official Contact | 5052703966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Interweave LLC 2100 Paseo Ponderosa Santa Fe NM 87501-6319 | Interweave LLC 2100 Paseo Ponderosa Santa Fe NM 87501-6319 Ph: (541) 306-8728 |
| NPI Number | 1881421931 |
|---|---|
| Provider Enumeration Date | 09/13/2024 |
| Last Update Date | 12/20/2024 |
| Certification Date | 12/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881421931 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | () | Primary |
| 101YP2500X | Counselor - Professional | () | Secondary |
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