| Chancetotake Llc | |
|
40 Gonzalitos Mesa Rd Miami NM 87729-2106 | |
| (575) 207-5234 | |
| (575) 207-5234 |
| Full Name | Chancetotake Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 40 Gonzalitos Mesa Rd, Miami, New Mexico |
| Authorized Official Name and Position | Morgan Nicole Sablotny (OWNER) |
| Authorized Official Contact | 5752075234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chancetotake Llc 40 Gonzalitos Mesa Rd Miami NM 87729-2106 Ph: (575) 207-5234 | Chancetotake Llc 40 Gonzalitos Mesa Rd Miami NM 87729-2106 Ph: (575) 207-5234 |
| NPI Number | 1558074708 |
|---|---|
| Provider Enumeration Date | 01/03/2023 |
| Last Update Date | 01/06/2023 |
| Certification Date | 01/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558074708 | NPI | - | NPPES |
| 42331749 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Chancetotake Llcc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Gonzalitos Mesa Rd, Miami, NM 87729 Phone: 575-207-5234 |