Organization
SOUTHWEST CARES NV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMINE MAROTTA (DIRECTOR OF OPERATIONS)
(505) 982-3113
Entity
Organization
Contact information
Practice address
119 EAST MARCY ST., SUITE 202, SANTA FE, NM 87501-2046
(505) 982-3113
Mailing address
P.O. BOX 32390, SANTA FE, NM 87594-2390
(505) 982-3113
(505) 982-2462
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/15/2010
Last updated
01/05/2016
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