MEDICARE: ELOYD R SAAVEDRA JR CPSW

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	175T00000X	Peer Specialist	1504	NM
2	171M00000X	Case Manager/Care Coordinator		NM

General Provider Information

NPI Number	:	1457065245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELOYD R SAAVEDRA JR CPSW

Provider Business Mailing Address
First Line	:	4010 CARLISLE BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4532
Country	:	US
Telephone Number	:	505-301-5297
Fax Number	:

Provider Business Practice Location Address
First Line	:	4010 CARLISLE BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-4532
Country	:	US
Telephone Number	:	505-301-5297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2023
Last Update Date	:	06/05/2026

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