Healthcare Provider Details

I. General information

NPI: 1871457689
Provider Name (Legal Business Name): EL CALVARIO UNITED METHODIST CHURCH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N MESQUITE ST
LAS CRUCES NM
88001-3527
US

IV. Provider business mailing address

240 N MESQUITE ST
LAS CRUCES NM
88001-3527
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-0142
  • Fax:
Mailing address:
  • Phone: 575-523-0142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: GEORGE MILLER
Title or Position: EXECUTIVE DIRECTOR
Credential: REV
Phone: 360-674-9822