| Los Alamos Family Council, Inc. | |
|
1350 Central Ave Ste 102 Los Alamos NM 87544-3218 | |
| (505) 662-4160 | |
| (505) 662-9707 |
| Full Name | Los Alamos Family Council, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 1350 Central Ave Ste 102, Los Alamos, New Mexico |
| Authorized Official Name and Position | Jordan Redmond (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5056624160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Los Alamos Family Council, Inc. 1350 Central Ave Ste 102 Los Alamos NM 87544-3218 Ph: (505) 662-3264 | Los Alamos Family Council, Inc. 1350 Central Ave Ste 102 Los Alamos NM 87544-3218 Ph: (505) 662-4160 |
| NPI Number | 1255374021 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 08/18/2023 |
| Certification Date | 08/18/2023 |
| Medicare PECOS PAC ID | 8325042302 |
|---|---|
| Medicare Enrollment ID | O20060905000594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255374021 | NPI | - | NPPES |
| N7745 | Medicaid | NM |
| Provider Name | Theresa Irene Wussow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831617265 PECOS PAC ID: 8820364672 Enrollment ID: I20171023000573 |
| Provider Name | Karla Leigh Palmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790377596 PECOS PAC ID: 6305299330 Enrollment ID: I20240125004739 |
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