| Rise Womens Self Recovery Llc | |
|
507 W Pueblo Dr Espanola NM 87532-2508 | |
| (505) 484-9154 | |
| Not Available |
| Full Name | Rise Womens Self Recovery Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 507 W Pueblo Dr, Espanola, New Mexico |
| Authorized Official Name and Position | Michelle Peixinho (THERAPIST) |
| Authorized Official Contact | 5054849154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rise Womens Self Recovery Llc Po Box 305 Chimayo NM 87522-0305 Ph: (505) 484-9154 | Rise Womens Self Recovery Llc 507 W Pueblo Dr Espanola NM 87532-2508 Ph: (505) 484-9154 |
| NPI Number | 1992313274 |
|---|---|
| Provider Enumeration Date | 07/22/2020 |
| Last Update Date | 07/22/2020 |
| Certification Date | 07/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992313274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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