Organization
NEW MEXICO WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELONIE BACOCCINI (OWNER)
(505) 362-0758
Entity
Organization
Contact information
Practice address
4210 MEADOWLARK LN SE, RIO RANCHO, NM 87124-1021
(505) 737-1858
Mailing address
4210 MEADOWLARK LN SE, RIO RANCHO, NM 87124-1021
(505) 737-1858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35808861
—
NM
Enumeration date
06/01/2022
Last updated
06/26/2026
Update your record
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