Healthcare Provider Details

I. General information

NPI: 1174418131
Provider Name (Legal Business Name): FLOW DE VIDA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 THOMAS DR NE
ALBUQUERQUE NM
87111-1953
US

IV. Provider business mailing address

5301 THOMAS DR NE
ALBUQUERQUE NM
87111-1953
US

V. Phone/Fax

Practice location:
  • Phone: 505-267-8934
  • Fax:
Mailing address:
  • Phone: 505-267-8934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELICA PENA FERNANDEZ
Title or Position: OWNER, CEO.
Credential: MS, LPCC.
Phone: 505-267-8934