Organization Name: | CALVARY COUNSELING SERVICE |
NPI Number: | 1023321213 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GARY HENDERSON (ADMINISTRATIVE DIRECTOR) |
Mailing Address: | 1800 S Locust St Las Cruces |
State: | NM US |
Postal Code: | 880015354 |
Phone Number: | 5755227900 |
Fax Number: | 5755227901 |
NPI Enumeration Date: | 07/16/2010 |
NPI Last Update Date: | 07/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 005708 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |