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Organization
TRIBAL COUNSELING AND WELLNESS CENTER LLC
Active
Organization
TRIBAL COUNSELING AND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO ORTIZ (CREDENTIALING MANAGER)
(575) 707-8150
Entity
Organization
Contact information
Practice address
707 N THIRD ST, GALLUP, NM 87301-5239
(505) 918-7955
Mailing address
PO BOX 57183, ALBUQUERQUE, NM 87187-7183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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