Healthcare Provider Details

I. General information

NPI: 1245978030
Provider Name (Legal Business Name): TRUE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2022
Last Update Date: 05/23/2022
Certification Date: 05/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 S MESA ST
CARLSBAD NM
88220-4828
US

IV. Provider business mailing address

213 S MESA ST
CARLSBAD NM
88220-4828
US

V. Phone/Fax

Practice location:
  • Phone: 575-725-5936
  • Fax: 575-725-5937
Mailing address:
  • Phone: 575-725-5936
  • Fax: 575-725-5937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREA CARRILLO
Title or Position: OWNER
Credential: CNP
Phone: 575-725-5936