Provider Demographics
NPI:1609657519
Name:CHIRON'S CAVE HOLISTIC LLC
Entity Type:Organization
Organization Name:CHIRON'S CAVE HOLISTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:541-919-4404
Mailing Address - Street 1:2103 GOLF COURSE RD SE STE A
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1764
Mailing Address - Country:US
Mailing Address - Phone:541-919-4404
Mailing Address - Fax:541-248-1147
Practice Address - Street 1:2103 GOLF COURSE RD SE STE A
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1764
Practice Address - Country:US
Practice Address - Phone:541-919-4404
Practice Address - Fax:541-248-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty