NPIMap

Organization Active NPI

Living & Wellness Center

Doing business as Professional Wellness Center

  • Community/Behavioral Health Agency
  • Las Cruces, NM
National Provider Identifier
1306071139
Registry record updated May 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LIVING & WELLNESS CENTER
Doing business as
Professional Wellness Center
Practice address
1100 S. Main Executive Suites
Las Cruces, NM 88005-2917
Phone
(575) 525-5635
Fax
(575) 647-8804
NPI assigned
May 22, 2009
Last updated
May 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Dimitris KollarosNPI 1598990327
Title
General Partner
Phone
(575) 640-3537

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1100 S. Main Executive Suites
Las Cruces, NM 88005-2917

Mailing address

1100 S. Main Executive Suites
Las Cruces, NM 88005-2917
Phone (575) 525-5635

Other names 1

  • Professional Wellness Center Doing business as

National Provider Directory

National Provider Directory

Locations

1100 S Main St
Las Cruces, NM 88005
Phone (505) 526-1105

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1306071139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S. MAIN EXECUTIVE SUITES",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052917",
            "telephone_number": "575-525-5635",
            "fax_number": "575-647-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S. MAIN EXECUTIVE SUITES",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052917",
            "telephone_number": "575-525-5635",
            "fax_number": "575-647-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING & WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-22",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "KOLLAROS",
        "authorized_official_first_name": "DIMITRIS",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "575-640-3537",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.