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Contact Information

LA LUZ PROVIDER AGENCY LLC
501 FRANKLIN AVE UNIT 6
SANTA FE, NM87501-3617
 Phone: 505-660-3484
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Art Therapist

221700000X
 

Counselor

101Y00000X
Indicates primary specialty

NPI Profile & details for LA LUZ PROVIDER AGENCY LLC

NPI Number 1245692102
LBN Legal business name LA LUZ PROVIDER AGENCY LLC
Authorized official CHERYL SCIACCA - (CO-OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/22/2016
Last updated 11/14/2024 - More than a year ago
Identifiers
NM Medicaid 96838272
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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