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1174005961
CHARISSE MERCEDES SOUTH
SANTA FE, NM
NPI
1174005961
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2018-08-29
Last Update Date
2018-08-29
Business Address
CHARISSE MERCEDES SOUTH BA
2960 RODEO PARK DR W
SANTA FE, NM 87505-6351
Phone number: 505-986-9633
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Mailing Address
CHARISSE MERCEDES SOUTH BA
1405 7TH ST
LAS VEGAS, NM 87701-4212
Phone number: 575-517-0162
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