MEDICARE: SOUTHWEST CARES NV LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1053632851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST CARES NV LLC

Provider Business Mailing Address
First Line	:	P.O. BOX 32390
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87594-2390
Country	:	US
Telephone Number	:	505-982-3113
Fax Number	:	505-982-2462

Provider Business Practice Location Address
First Line	:	119 EAST MARCY ST.
Second Line	:	SUITE 202
City	:	SANTA FE
State	:	NM
Zip	:	87501-2046
Country	:	US
Telephone Number	:	505-982-3113
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	CARMINE MAROTTA
Credential	:
Telephone Number	:	505-982-3113

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	01/05/2016

Similar Medicare Providers

1538277058 — DR. DENNIS MICHAEL BEAUFAIT ED D
Practice Location Address:

119 E MARCY ST STE 202
SANTA FE, NM
87501-2046

Practice Phone: 888-982-3113
Practice Fax:

1174517791 — JOHN P O'CONNOR PT
Practice Location Address:

22521 AVENIDA EMPRESA STE 116
RANCHO SANTA MARGARITA, CA
92688-2046

Practice Phone: 949-766-8535
Practice Fax: 949-766-8540

1619199791 — STEPHANIE CANALE M.D.
Practice Location Address:

2428 SANTA MONICA BLVD STE 200
SANTA MONICA, CA
90404-2046

Practice Phone: 310-998-5868
Practice Fax:

1679910020 — DR. HOLLY MEHR MD
Practice Location Address:

2428 SANTA MONICA BLVD STE 301
SANTA MONICA, CA
90404-2046

Practice Phone: 805-778-1122
Practice Fax: 805-778-1199

1609310119 — KASSANDRA WALKOWIAK D.C.
Practice Location Address:

2428 SANTA MONICA BLVD STE 308
SANTA MONICA, CA
90404-2046

Practice Phone: 310-453-8393
Practice Fax: 310-453-8696

1326584277 — HEALTH ATLAST WEST LA
Practice Location Address:

2428 SANTA MONICA BLVD STE 308
SANTA MONICA, CA
90404-2046

Practice Phone: 310-453-8393
Practice Fax: 310-453-8696

Directions to “SOUTHWEST CARES NV LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.