Healthcare Provider Details

I. General information

NPI: 1285137448
Provider Name (Legal Business Name): CHRISTINA R ARENIBAS LSAA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S COPPER ST
DEMING NM
88030-3610
US

IV. Provider business mailing address

118 W 13TH ST
SILVER CITY NM
88061-5139
US

V. Phone/Fax

Practice location:
  • Phone: 575-590-8886
  • Fax: 575-546-4362
Mailing address:
  • Phone: 575-388-1447
  • Fax: 515-388-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0191281
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: