Healthcare Provider Details

I. General information

NPI: 1386566388
Provider Name (Legal Business Name): CONCIERGE HEALTH AND WELLNESS MASSAGE AND SPA LTD CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7804 PAN AMERICAN FREEWAY NE SUITE 2
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

7804 PAN AMERICAN FREEWAY NE SUITE 2
ALBUQUERQUE NM
87109
US

V. Phone/Fax

Practice location:
  • Phone: 505-305-5615
  • Fax:
Mailing address:
  • Phone: 505-305-5615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: CALVIN DUCANE WARD
Title or Position: OWNER
Credential:
Phone: 505-305-5615