Organization
PINE PSYCHIATRIC CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCY ITESA PMHNP (OWNER)
(505) 361-6580
Entity
Organization
Contact information
Practice address
500 MARQUETTE AVE NW STE 1200, ALBUQUERQUE, NM 87102-5312
(505) 361-6580
(505) 717-4007
Mailing address
500 MARQUETTE AVE NW STE 1200, ALBUQUERQUE, NM 87102-5312
(505) 361-6580
(505) 717-4007
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/14/2021
Last updated
02/14/2023
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