Provider Demographics
NPI:1780016600
Name:PADILLA THERAPIES, INC
Entity Type:Organization
Organization Name:PADILLA THERAPIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.S.,CCC/SLP
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:PADILLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-443-3046
Mailing Address - Street 1:1809 W RUNYAN AVE
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-2551
Mailing Address - Country:US
Mailing Address - Phone:575-443-3046
Mailing Address - Fax:
Practice Address - Street 1:1809 W RUNYAN AVE
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-2551
Practice Address - Country:US
Practice Address - Phone:575-443-3046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2673251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services