| Nuevo Amanecer Llc | |
|
2312 S Meridian Ave Ste 102 Wichita KS 67213-1912 | |
| (316) 807-5055 | |
| Not Available |
| Full Name | Nuevo Amanecer Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2312 S Meridian Ave Ste 102, Wichita, Kansas |
| Authorized Official Name and Position | Carmen Maria Aguilar (OWNER) |
| Authorized Official Contact | 3168075055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nuevo Amanecer Llc 2750 S Glenn Ave Wichita KS 67217-1843 Ph: (316) 807-5055 | Nuevo Amanecer Llc 2312 S Meridian Ave Ste 102 Wichita KS 67213-1912 Ph: (316) 807-5055 |
| NPI Number | 1659997682 |
|---|---|
| Provider Enumeration Date | 06/25/2020 |
| Last Update Date | 12/08/2021 |
| Certification Date | 12/08/2021 |
| Medicare PECOS PAC ID | 6507256203 |
|---|---|
| Medicare Enrollment ID | O20211213001963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659997682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Carmen Maria Aguilar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942597505 PECOS PAC ID: 8224428925 Enrollment ID: I20211213002017 |
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