Healthcare Provider Details

I. General information

NPI: 1992243513
Provider Name (Legal Business Name): EPOCH INTEGRATED HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2017
Last Update Date: 02/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S MAIN ST
LAS CRUCES NM
88001-1278
US

IV. Provider business mailing address

250 S MAIN ST
LAS CRUCES NM
88001-1278
US

V. Phone/Fax

Practice location:
  • Phone: 575-525-8484
  • Fax: 855-324-2329
Mailing address:
  • Phone: 575-525-8484
  • Fax: 855-324-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: JANA L SMITH
Title or Position: CEO
Credential:
Phone: 575-525-8484