Organization
CALVARY COUNSELING SERVICE
Active
Organization
CALVARY COUNSELING SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY HENDERSON (ADMINISTRATIVE DIRECTOR)
(575) 522-7900
Entity
Organization
Contact information
Practice address
1800 S LOCUST ST, LAS CRUCES, NM 88001-5354
(575) 522-7900
(575) 522-7901
Mailing address
1800 S LOCUST ST, LAS CRUCES, NM 88001-5354
(575) 522-7900
(575) 522-7901
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
005708
NM
101YP2500X
Professional Counselor
Primary
0076651
NM
Other
Enumeration date
07/16/2010
Last updated
07/16/2010
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