Or Factor | |
400 N Pennsylvania Ave Ste 670b Roswell NM 88201 | |
(575) 420-7336 | |
(575) 627-5721 |
Full Name | Or Factor |
---|---|
Speciality | Community/Behavioral Health |
Location | 400 N Pennsylvania Ave Ste 670b, Roswell, New Mexico |
Authorized Official Name and Position | Kimberly Shannon Byrne (OWNER) |
Authorized Official Contact | 5754207336 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Or Factor 400 N Pennsylvania Ave Ste 670b Roswell NM 88201 Ph: (575) 420-7336 | Or Factor 400 N Pennsylvania Ave Ste 670b Roswell NM 88201 Ph: (575) 420-7336 |
NPI Number | 1285177675 |
---|---|
Provider Enumeration Date | 12/02/2016 |
Last Update Date | 01/08/2018 |
Medicare PECOS PAC ID | 8325300817 |
---|---|
Medicare Enrollment ID | O20180321001267 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285177675 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Kimberly Shannon Byrne |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831325828 PECOS PAC ID: 6901040377 Enrollment ID: I20130925000429 |
Provider Name | Sylvia Baltazar |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1477886414 PECOS PAC ID: 8628307568 Enrollment ID: I20190903000696 |
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