Healthcare Provider Details
I. General information
NPI: 1720373004
Provider Name (Legal Business Name): WHFP,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/14/2011
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2865 CERRILLOS RD
SANTA FE NM
87507-2311
US
IV. Provider business mailing address
PO BOX 22267
SANTA FE NM
87502-2267
US
V. Phone/Fax
- Phone: 505-603-9373
- Fax: 505-473-0044
- Phone: 505-603-9373
- Fax: 505-473-0044
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
LORRAINE
HERRERA
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 505-603-9373