Provider Demographics
NPI:1083128607
Name:P CELESTE, INC.
Entity Type:Organization
Organization Name:P CELESTE, INC.
Other - Org Name:CELESTIAL HEARING SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:CELESTE
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:575-232-9022
Mailing Address - Street 1:2001 E LOHMAN AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3198
Mailing Address - Country:US
Mailing Address - Phone:575-232-9022
Mailing Address - Fax:575-288-2701
Practice Address - Street 1:2001 E LOHMAN AVE STE 112
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001
Practice Address - Country:US
Practice Address - Phone:575-232-9022
Practice Address - Fax:575-288-2701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0897237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM20736576Medicaid
NM032955690OtherDRIVER LICENSE