Healthcare Provider Details

I. General information

NPI: 1801676945
Provider Name (Legal Business Name): BEGIN AGAIN THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2023
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 GEORGIA ST NE
ALBUQUERQUE NM
87110-1359
US

IV. Provider business mailing address

PO BOX 14962
ALBUQUERQUE NM
87191-4962
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-4877
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE ANN MARIE BACA
Title or Position: OWNER, THERAPIST
Credential:
Phone: 505-514-8503