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NPI Code Detail

MEDICARE: INTERNAL STRENGTH INC

MEDICARE: INTERNAL STRENGTH INC
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1396570586
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERNAL STRENGTH INC
Provider Business Mailing Address
First Line : 2435 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5029
Country : US
Telephone Number : 575-323-1315
Fax Number : 833-524-5203
Provider Business Practice Location Address
First Line : 2435 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5029
Country : US
Telephone Number : 575-323-1315
Fax Number : 833-524-5203
Authorized Official
Title or Position : OWNER
Name : THERESA ONTIVEROS
Credential :
Telephone Number : 575-323-1315
Provider Enumeration Date : 09/05/2024
Last Update Date : 09/05/2024

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