Healthcare Provider Details

I. General information

NPI: 1225946759
Provider Name (Legal Business Name): A PEACEFUL HABITATION HOME & AFTERCARE MINISTRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9910 INDIAN SCHOOL RD NE STE 208
ALBUQUERQUE NM
87112-2971
US

IV. Provider business mailing address

PO BOX 53516
ALBUQUERQUE NM
87153-3516
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-5937
  • Fax: 877-986-9227
Mailing address:
  • Phone: 505-440-5937
  • Fax: 877-986-9227

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: LETICIA CHAVEZ-PAULETTE
Title or Position: EXECUTIVE DIRECTOR
Credential: CPSW, CSW
Phone: 505-267-5090