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General NPI Number Information
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NPI Number | 1902437817
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Entity Type | Organization
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Legal Business Name | PIECES FAMILY SERVICES
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Dates
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Enumeration Date | 01/29/2020
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 2019 GALISTEO ST STE M5
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City | SANTA FE
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State | NM
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Zip | 87505-2106
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Country | US
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Telephone | 505-982-0191
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Fax |
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Provider Business Mailing Address
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Address Line | 2255 CAMINO IRIS
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City | SANTA FE
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State | NM
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Zip | 87505-4953
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CONTRACTING MANAGER
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Name | TOMAS WEILER
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Credential |
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Telephone | 505-433-2755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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