Healthcare Provider Details

I. General information

NPI: 1629610597
Provider Name (Legal Business Name): CIMA VENTURES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2019
Last Update Date: 10/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10131 COORS BLVD NW STE H7
ALBUQUERQUE NM
87114-4048
US

IV. Provider business mailing address

9600 CAMINO DEL SOL NE
ALBUQUERQUE NM
87111-1531
US

V. Phone/Fax

Practice location:
  • Phone: 505-217-9118
  • Fax:
Mailing address:
  • Phone: 505-550-1607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL W NOBLE
Title or Position: OWNER
Credential:
Phone: 505-480-3219