Provider Demographics
NPI:1285177675
Name:OR FACTOR
Entity type:Organization
Organization Name:OR FACTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SHANNON
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:575-420-7336
Mailing Address - Street 1:400 N PENNSYLVANIA AVE STE 670C
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-4755
Mailing Address - Country:US
Mailing Address - Phone:575-623-7336
Mailing Address - Fax:575-623-7337
Practice Address - Street 1:400 N PENNSYLVANIA AVE STE 670C
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-4755
Practice Address - Country:US
Practice Address - Phone:575-420-7336
Practice Address - Fax:575-627-5721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty