Organization
ON WINGS LIKE EAGLES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD GENE KRUIS LPCC, LADAC (OWNER/PROVIDER)
(575) 650-0071
Entity
Organization
Contact information
Practice address
1435 PECOS ST, LAS CRUCES, NM 88001-4335
(575) 522-1422
(575) 532-5175
Mailing address
1801 LAS TUNAS DR, LAS CRUCES, NM 88011-4956
(575) 522-1422
(575) 532-5175
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
03-130243-00-2
NM
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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