Provider Demographics
NPI:1396427928
Name:CEDAR RIDGE THERAPY, LLC
Entity type:Organization
Organization Name:CEDAR RIDGE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MONTEITH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:575-322-6551
Mailing Address - Street 1:102 PINEWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PIE TOWN
Mailing Address - State:NM
Mailing Address - Zip Code:87827
Mailing Address - Country:US
Mailing Address - Phone:575-322-6551
Mailing Address - Fax:
Practice Address - Street 1:102 PINEWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:PIE TOWN
Practice Address - State:NM
Practice Address - Zip Code:87827
Practice Address - Country:US
Practice Address - Phone:575-322-6551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)