Provider Demographics
NPI:1568155653
Name:GUIDING STAR SOUTHWEST LLC
Entity Type:Organization
Organization Name:GUIDING STAR SOUTHWEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVALIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-313-2277
Mailing Address - Street 1:1411 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5617
Mailing Address - Country:US
Mailing Address - Phone:915-544-9600
Mailing Address - Fax:
Practice Address - Street 1:1411 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5617
Practice Address - Country:US
Practice Address - Phone:915-544-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing
No251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No291U00000XLaboratoriesClinical Medical Laboratory