Provider Demographics
NPI:1376163030
Name:CENTER FOR COLLECTIVE WELLNESS LLC
Entity Type:Organization
Organization Name:CENTER FOR COLLECTIVE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HINDASH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:575-386-5254
Mailing Address - Street 1:3855 FOOTHILLS RD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4772
Mailing Address - Country:US
Mailing Address - Phone:575-386-5254
Mailing Address - Fax:
Practice Address - Street 1:3855 FOOTHILLS RD STE C
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4772
Practice Address - Country:US
Practice Address - Phone:575-496-7762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-23
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty