Provider Demographics
NPI:1891688636
Name:PECOS VALLEY PUBLIC SERVICES
Entity type:Organization
Organization Name:PECOS VALLEY PUBLIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERZ
Authorized Official - Suffix:
Authorized Official - Credentials:NRAEMT
Authorized Official - Phone:832-757-8388
Mailing Address - Street 1:200 W 1ST ST STE 516
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88203-4676
Mailing Address - Country:US
Mailing Address - Phone:505-600-3068
Mailing Address - Fax:
Practice Address - Street 1:200 W 1ST ST STE 516
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4676
Practice Address - Country:US
Practice Address - Phone:505-600-3068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM303311OtherSTATE OF NEW MEXICO