Mesa Vista Wellness

LBN: Earth Spirit Awakenings Llc
Mesa Vista Wellness is an health care organization with primary practice located at 4001 Office Court Dr Ste 102 , Santa Fe NM 87507-4903. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Earth Spirit Awakenings Llc can be contacted via phone (505) 983-8225, or through Dicecco, Tod L via phone (505) 490-1984.

Contact Information

Primary practice address
4001 Office Court Dr Ste 102 Santa Fe NM 87507-4903
Phone: (505) 983-8225
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Dicecco, Tod L MA, LPCC
Phone: (505) 490-1984

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 0119891 New Mexico
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1447490800
LBN Legal business name Earth Spirit Awakenings Llc
DBA Doing business as Mesa Vista Wellness
Authorized official Dicecco, Tod L MA, LPCC
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2009
Last updated Feb 10th, 2022 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447490800 NPPES
New Mexico MEDICAID 81024371

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