MEDICARE: CIMA VENTURES, 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	225X00000X	Occupational Therapist
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1629610597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIMA VENTURES, LLC

Provider Business Mailing Address
First Line	:	9600 CAMINO DEL SOL NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-1531
Country	:	US
Telephone Number	:	505-550-1607
Fax Number	:

Provider Business Practice Location Address
First Line	:	10131 COORS BLVD NW STE H7
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-4048
Country	:	US
Telephone Number	:	505-217-9118
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL W NOBLE
Credential	:
Telephone Number	:	505-480-3219

Provider Enumeration Date	:	10/11/2019
Last Update Date	:	10/11/2019

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Directions to “CIMA VENTURES, LLC ” Practice Location

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