Organization
WHITE MOUNTAIN WELLNESS LLC
Active
Other names
White Mountain Wellness LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT NICHOLS (GENERAL MANAGER)
(575) 937-3688
Entity
Organization
Contact information
Practice address
159 MESCALERO TRL STE 5, RUIDOSO, NM 88345-6089
(575) 937-3688
Mailing address
PO BOX 655, RUIDOSO, NM 88355-0655
(844) 337-5283
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
0055C
NM
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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