Provider Demographics
NPI:1558536946
Name:HIGH DESERT HOLISTIC HEALTH CARE & PAIN MANAGEMENT
Entity Type:Organization
Organization Name:HIGH DESERT HOLISTIC HEALTH CARE & PAIN MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PALUSZEK-PIRC
Authorized Official - Suffix:
Authorized Official - Credentials:DN,MPH
Authorized Official - Phone:575-437-3270
Mailing Address - Street 1:911 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-6423
Mailing Address - Country:US
Mailing Address - Phone:575-437-3270
Mailing Address - Fax:575-437-3371
Practice Address - Street 1:911 10TH ST
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6423
Practice Address - Country:US
Practice Address - Phone:575-437-3270
Practice Address - Fax:575-437-3371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0009302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization