Provider Demographics
NPI:1770699936
Name:MECA, LLC
Entity type:Organization
Organization Name:MECA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PERSONNEL
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:S
Authorized Official - Last Name:GALLEGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-526-1161
Mailing Address - Street 1:780 S WALNUT ST
Mailing Address - Street 2:BLDG #7
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1425
Mailing Address - Country:US
Mailing Address - Phone:505-526-1161
Mailing Address - Fax:505-523-1108
Practice Address - Street 1:1350 HILLRISE CIRCLE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001
Practice Address - Country:US
Practice Address - Phone:505-526-1161
Practice Address - Fax:505-523-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation