Healthcare Provider Details

I. General information

NPI: 1518641091
Provider Name (Legal Business Name): RHIZOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 05/22/2024
Certification Date: 05/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 INDIAN SCHOOL RD NE STE 106
ALBUQUERQUE NM
87112-2862
US

IV. Provider business mailing address

9301 INDIAN SCHOOL RD NE STE 106
ALBUQUERQUE NM
87112-2862
US

V. Phone/Fax

Practice location:
  • Phone: 505-365-0090
  • Fax: 505-349-4920
Mailing address:
  • Phone: 505-365-0090
  • Fax: 505-359-4920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. RAVEN JOYCE HARLEY
Title or Position: OWNER
Credential: D.O.M.
Phone: 505-523-7611