Provider Demographics
NPI:1245733583
Name:PRACTICAL SOLUTIONS ENTERPRISES, LLC
Entity type:Organization
Organization Name:PRACTICAL SOLUTIONS ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:575-208-0028
Mailing Address - Street 1:PO BOX 640
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88102-0640
Mailing Address - Country:US
Mailing Address - Phone:575-208-0028
Mailing Address - Fax:575-680-1075
Practice Address - Street 1:501 COMMERCE WAY STE 6
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4870
Practice Address - Country:US
Practice Address - Phone:575-208-0028
Practice Address - Fax:575-680-1075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty