person
Mr. Jesse Lee Baca, LSAA
Addiction (Substance Use Disorder) Counselor in Las Vegas, New Mexico
NPI 1972151728

Jesse Lee Baca is an Addiction (Substance Use Disorder) Counselor based in Espanola, NM and is specialized in Addiction (Substance Use Disorder). Jesse Lee Baca practices in Las Vegas, NM and has the professional credentials of LSAA. The NPI Number for Jesse Lee Baca is 1972151728 and holds a License No. CSA0205961 (New Mexico).

The current practice location address for Jesse Lee Baca is 1235 8Th St, Las Vegas, NM and can be reached out via phone at 505-425-6788. You can also correspond with Jesse Lee Baca through the mailing address at PO BOX 158, ESPANOLA, NM - 87532-0158 (mailing address contact number: 505-753-7218).

Location: 1235 8Th St, Las Vegas, NM, 87532-0158
person
Provider Profile Details
NPI Number
1972151728
Provider Name
Jesse Lee Baca
Credential
LSAA
Provider Entity Type
Individual
Gender
Male
Address
1235 8Th St, Las Vegas, NM, 87532-0158
Phone Number
505-425-6788
Fax Number
Provider Enumeration Date
08/26/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1235 8Th St
City
State
Zip
87701-4219
Phone Number
505-425-6788
Fax Number
person
Provider Business Mailing Address Details
Address
Po Box 158
City
State
Zip
87532-0158
Phone Number
505-753-7218
Fax Number
505-426-3492
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
CSA0205961 (New Mexico)
Definition
Definition to come...
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