Provider Demographics
NPI:1912225087
Name:TORENO, MICHAEL H (CADAC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:H
Last Name:TORENO
Suffix:
Gender:M
Credentials:CADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 1ST STREET
Mailing Address - Street 2:49 MEDICAL GROUP
Mailing Address - City:HOLLOMAN AFB
Mailing Address - State:NM
Mailing Address - Zip Code:88330-8273
Mailing Address - Country:US
Mailing Address - Phone:509-863-2546
Mailing Address - Fax:
Practice Address - Street 1:280 1ST STREET
Practice Address - Street 2:49 MEDICAL GROUP
Practice Address - City:HOLLOMAN AFB
Practice Address - State:NM
Practice Address - Zip Code:88330-8273
Practice Address - Country:US
Practice Address - Phone:509-863-2546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)