Healthcare Provider Details

I. General information

NPI: 1467228221
Provider Name (Legal Business Name): H2 ACADEMIC SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 BECKER AVE
BELEN NM
87002-3632
US

IV. Provider business mailing address

506 BECKER AVE
BELEN NM
87002-3632
US

V. Phone/Fax

Practice location:
  • Phone: 505-453-3621
  • Fax:
Mailing address:
  • Phone: 505-453-3621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: HOLLY CHAVEZ
Title or Position: OWNER
Credential:
Phone: 505-453-3621