NKE NEW LEAF LLC NPI 1366796724

NPI Information

NPI: 1366796724
Provider Name: NKE NEW LEAF LLC

Doing Business As: NEW LEAF WELLNESS CENTER

Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
10921 PELLICANO DR STE 110
EL PASO, TX
ZIP 79935
Phone: (915) 313-4114
Get Directions

NKE NEW LEAF LLC is a professional counselor in El Paso, TX. NKE NEW LEAF LLC NPI is 1366796724. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As New Leaf Wellness Center.

The provider's business location address is:

10921 PELLICANO DR STE 110
EL PASO, TX
ZIP 79935
Phone: (915) 313-4114
Fax: (915) 313-4939

The provider's authorized official is Noe Antonio Lopez .
The authorized official title is Ceo and has the following contact phone number (915) 313-4114.

The enumeration date for this NPI number is 11/6/2012 and was last updated on 9/1/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	66155	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3898868	MEDICAID	TEXAS
2	2915829	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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