Zane Romancito, LADAC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Zuni, NM

NPI 1275867772 · NPPES record last updated Jul 11, 2011

Key facts

NPI
1275867772
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
005837 (NM)
Practice address
99 D Ave
Black Rock
Zuni, NM 87327
Phone
(505) 782-4710
Fax
(505) 782-5880
NPI assigned
Sep 30, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005837NMMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 005837 NM Yes

Addresses

Primary practice location

99 D Ave
Black Rock
Zuni, NM 87327

Mailing address

PO Box 339
C/O Zuni Recovery Center
Zuni, NM 87327-0339
Phone (505) 782-4710

Other identifiers

IdentifierTypeStateIssuer
28905512MedicaidNM

Other providers in Zuni, NM

All providers in Zuni, NM · Addiction (Substance Use Disorder) Counselor in New Mexico

Sources for this page

Verify at the official NPI Registry.