institution
Modern Mystic, Llc
Mental Health Clinic/Center (Including Community Mental Health Center) in Santa Fe, New Mexico
NPI 1720445679

Modern Mystic, Llc is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Santa Fe, NM and is specialized in Mental Health (Including Community Mental Health Center). Modern Mystic, Llc practices in Santa Fe, NM. The NPI Number for Modern Mystic, Llc is 1720445679 and holds a License No. T-0174411 (New Mexico).

The current practice location address for Modern Mystic, Llc is 2213 Brothers Rd, Santa Fe, NM and can be reached out via phone at 505-988-7616.

Location: 2213 Brothers Rd, Santa Fe, NM, 87508-8793
institution
Provider Profile Details
NPI Number
1720445679
Provider Name
Modern Mystic, Llc
Credential
Provider Entity Type
Organization
Address
2213 Brothers Rd, Santa Fe, NM, 87508-8793
Phone Number
505-988-7616
Fax Number
Provider Enumeration Date
01/23/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2213 Brothers Rd
City
State
Zip
87505-6993
Phone Number
505-988-7616
Fax Number
person
Provider Business Mailing Address Details
Address
2213 Brothers Rd
City
State
Zip
87505-6993
Phone Number
505-988-7616
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
T-0174411 (New Mexico)
Definition
Definition to come...
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