Organization
TRIBAL COUNSELING AND WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO ORTIZ (CREDENTIALING MANAGER)
(575) 707-8150
Entity
Organization
Contact information
Practice address
707 N THIRD ST, GALLUP, NM 87301-5239
(505) 918-7955
Mailing address
PO BOX 57183, ALBUQUERQUE, NM 87187-7183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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