Horizon Healthcare Of New Mexico Inc | |
1209 Mountain Road Pl Ne Ste R Albuquerque NM 87110-7845 | |
(414) 376-5577 | |
Not Available |
Full Name | Horizon Healthcare Of New Mexico Inc |
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Speciality | Community/Behavioral Health |
Location | 1209 Mountain Road Pl Ne Ste R, Albuquerque, New Mexico |
Authorized Official Name and Position | Karl Rajani (PRESIDENT) |
Authorized Official Contact | 4145810582 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Horizon Healthcare Of New Mexico Inc 217 Wisconsin Ave Ste 201 Waukesha WI 53186-4946 Ph: (414) 376-5577 | Horizon Healthcare Of New Mexico Inc 1209 Mountain Road Pl Ne Ste R Albuquerque NM 87110-7845 Ph: (414) 376-5577 |
NPI Number | 1366270670 |
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Provider Enumeration Date | 07/26/2024 |
Last Update Date | 08/23/2024 |
Medicare PECOS PAC ID | 1456884600 |
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Medicare Enrollment ID | O20241028001407 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366270670 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Shalonda N Myles |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659569929 PECOS PAC ID: 5092143750 Enrollment ID: I20241028001626 |
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