Healthcare Provider Details
I. General information
NPI: 1366235558
Provider Name (Legal Business Name): TRIBEAID INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
824 MOUNT TAYLOR AVE
GRANTS NM
87020-2959
US
IV. Provider business mailing address
269 GENE AVE NW
ALBUQUERQUE NM
87107-5316
US
V. Phone/Fax
- Phone: 505-610-5897
- Fax:
- Phone: 505-469-8768
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TERESA
MEEHAN
Title or Position: CEO
Credential:
Phone: 505-610-5897