| Neurogenesis | |
|
613 Canyon Rd Santa Fe NM 87501-2721 | |
| (575) 654-2919 | |
| Not Available |
| Full Name | Neurogenesis |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 613 Canyon Rd, Santa Fe, New Mexico |
| Authorized Official Name and Position | Teresa Dahlin (OWNER) |
| Authorized Official Contact | 5756542919 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurogenesis 613 Canyon Rd Santa Fe NM 87501-2721 | Neurogenesis 613 Canyon Rd Santa Fe NM 87501-2721 Ph: (575) 654-2919 |
| NPI Number | 1558805895 |
|---|---|
| Provider Enumeration Date | 12/06/2016 |
| Last Update Date | 12/06/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558805895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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