Josefa, Rose
Josefa, Rose is an individual health care provider with primary practice located at 700 Friedman Ave , Las Vegas NM 87701-4231. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Josefa, Rose can be contacted via phone (505) 454-5100.Contact Information
Primary practice address
700 Friedman Ave
Las Vegas NM 87701-4231
Phone: (505) 454-5100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I4209 | New Mexico |
Profile Details
| NPI number | 1790873354 |
|---|---|
| LBN Legal business name | Josefa, Rose |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 10th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790873354 | NPPES |
| New Mexico | MEDICAID | B7596 |
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