Healthcare Provider Details

I. General information

NPI: 1386322428
Provider Name (Legal Business Name): HIGHER HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7203 4TH ST NW
LOS RANCHOS NM
87107-6623
US

IV. Provider business mailing address

7203 4TH ST NW
LOS RANCHOS NM
87107-6623
US

V. Phone/Fax

Practice location:
  • Phone: 505-697-7113
  • Fax:
Mailing address:
  • Phone: 505-433-3994
  • Fax: 505-433-2748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREA MALONEY
Title or Position: OWNER
Credential: CNP
Phone: 505-697-7113