MEDICARE: FLOW DE VIDA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174418131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOW DE VIDA

Provider Business Mailing Address
First Line	:	5301 THOMAS DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-1953
Country	:	US
Telephone Number	:	505-267-8934
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 THOMAS DR NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-1953
Country	:	US
Telephone Number	:	505-267-8934
Fax Number	:

Authorized Official
Title or Position	:	OWNER, CEO.
Name	:	ANGELICA PENA FERNANDEZ
Credential	:	MS, LPCC.
Telephone Number	:	505-267-8934

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	06/10/2025

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Directions to “FLOW DE VIDA ” Practice Location

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