JESSE LEE BACA

LAS VEGAS, NM
NPI1972151728
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: NM  CSA0205961)
Enumeration Date2019-08-26
Last Update Date2019-08-26
Business Address
MR. JESSE LEE BACA LSAA
1235 8TH ST
LAS VEGAS, NM 87701-4219
Phone number: 505-425-6788
Mailing Address
MR. JESSE LEE BACA LSAA
PO BOX 158
ESPANOLA, NM 87532-0158
Phone number: 505-753-7218
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