Organization
ON THE BRIGHT SIDE RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB PENA CPSW (CERTIFIED PEER SUPPORT WORKER)
(575) 312-0676
Entity
Organization
Contact information
Practice address
800 S TORNILLO ST, LAS CRUCES, NM 88001-3360
(575) 312-0676
Mailing address
809 S SAN PEDRO ST, LAS CRUCES, NM 88001-3634
(575) 312-0676
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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