Healthcare Provider Details

I. General information

NPI: 1699937151
Provider Name (Legal Business Name): HOGARES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 CONDERSHIRE DR SW
ALBUQUERQUE NM
87121-5253
US

IV. Provider business mailing address

3701 CONDERSHIRE DR SW
ALBUQUERQUE NM
87121-5253
US

V. Phone/Fax

Practice location:
  • Phone: 505-873-1431
  • Fax:
Mailing address:
  • Phone: 505-873-1431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberT-0111111
License Number StateNM

VIII. Authorized Official

Name: MISS SUSAN MARGARET MESSAL
Title or Position: LMHC/ THERAPIST
Credential: LMHC
Phone: 505-873-1431