Healthcare Provider Details

I. General information

NPI: 1700742111
Provider Name (Legal Business Name): TAO PATHWAYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 W ORGAN AVE
LAS CRUCES NM
88005-2626
US

IV. Provider business mailing address

604 W ORGAN AVE
LAS CRUCES NM
88005-2626
US

V. Phone/Fax

Practice location:
  • Phone: 505-453-4169
  • Fax:
Mailing address:
  • Phone: 505-453-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: GEORGE MOSCONA
Title or Position: OWNER
Credential:
Phone: 505-453-4169