| Luxe Psychiatric And Wellness Services Llc | |
|
613 W 2nd St Ste 3 Roswell NM 88201-4671 | |
| (210) 900-0729 | |
| (575) 627-5721 |
| Full Name | Luxe Psychiatric And Wellness Services Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 613 W 2nd St Ste 3, Roswell, New Mexico |
| Authorized Official Name and Position | Lynnet Bulambo (OWNER) |
| Authorized Official Contact | 5758404888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luxe Psychiatric And Wellness Services Llc 401 Mission Arch Dr Roswell NM 88201-6792 Ph: (575) 840-4888 | Luxe Psychiatric And Wellness Services Llc 613 W 2nd St Ste 3 Roswell NM 88201-4671 Ph: (210) 900-0729 |
| NPI Number | 1386283943 |
|---|---|
| Provider Enumeration Date | 12/31/2019 |
| Last Update Date | 03/14/2020 |
| Certification Date | 03/14/2020 |
| Medicare PECOS PAC ID | 5496184798 |
|---|---|
| Medicare Enrollment ID | O20200408001662 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386283943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Lynnet M Bulambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063891307 PECOS PAC ID: 3173957032 Enrollment ID: I20191231000460 |
| Provider Name | Moses Bulambo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104410331 PECOS PAC ID: 9537575923 Enrollment ID: I20210310000193 |
| Provider Name | Samwel Rorya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811651136 PECOS PAC ID: 3870980832 Enrollment ID: I20220422000386 |
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