Organization
SEAN HOLMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HERNANDEZ (HUMAN RESOURCE ASSISTANT)
(575) 647-2876
Entity
Organization
Contact information
Practice address
100 W GRIGGS AVE, LAS CRUCES, NM 88001-1234
(575) 647-2869
(575) 647-2898
Mailing address
100 W GRIGGS AVE, LAS CRUCES, NM 88001-1234
(575) 647-2869
(575) 647-2898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3904
NM
101YM0800X
Mental Health Counselor
Primary
X06328
NM
Other
Enumeration date
06/25/2006
Last updated
08/12/2008
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