Individual
DAVID PADILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
303 N ALAMEDA BLVD, LAS CRUCES, NM 88005-2590
(575) 523-0111
Mailing address
303 N ALAMEDA BLVD, LAS CRUCES, NM 88005-2590
(575) 523-0111
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
1139
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
821556068
—
NM
Enumeration date
06/08/2021
Last updated
06/08/2021
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