Provider Demographics
NPI:1831508464
Name:HEALTH CENTER
Entity type:Organization
Organization Name:HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:505-204-4241
Mailing Address - Street 1:18468 C PRIVATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ARROYO SECO
Mailing Address - State:NM
Mailing Address - Zip Code:87532
Mailing Address - Country:US
Mailing Address - Phone:505-753-7576
Mailing Address - Fax:505-753-7676
Practice Address - Street 1:18468 PRIVATE DRIVE
Practice Address - Street 2:C
Practice Address - City:ARROYO SECO
Practice Address - State:NM
Practice Address - Zip Code:87532
Practice Address - Country:US
Practice Address - Phone:505-753-7576
Practice Address - Fax:505-753-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM7022172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty