Organization
SAGE NEUROSCIENCE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REUBEN SUTTER M.D. (OWNER)
(505) 884-1114
Entity
Organization
Contact information
Practice address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 359-3010
Mailing address
7850 JEFFERSON ST NE STE 300, ALBUQUERQUE, NM 87109-4314
(505) 884-1114
(505) 359-3010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MD2005-0751
NM
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962463877
INDIVIDUAL NPI
NM
Enumeration date
10/18/2006
Last updated
11/15/2022
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