Healthcare Provider Details

I. General information

NPI: 1275357162
Provider Name (Legal Business Name): HEART HEALING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2024
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-1908
US

IV. Provider business mailing address

1109 11TH ST SE
RIO RANCHO NM
87124-3548
US

V. Phone/Fax

Practice location:
  • Phone: 505-750-0405
  • Fax:
Mailing address:
  • Phone: 505-929-2242
  • 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: AMANDA PLEASE SELECT MOE
Title or Position: OWNER
Credential: LPCC
Phone: 505-929-2242