Healthcare Provider Details

I. General information

NPI: 1891512273
Provider Name (Legal Business Name): STRENGTHENED FOUNDATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 THOREAU MEADOWS DR NE
RIO RANCHO NM
87144-8561
US

IV. Provider business mailing address

3125 THOREAU MEADOWS DR NE
RIO RANCHO NM
87144-8561
US

V. Phone/Fax

Practice location:
  • Phone: 505-401-6615
  • Fax:
Mailing address:
  • Phone: 505-401-6615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SHANNON OVIENE SPILSBURY
Title or Position: OWNER
Credential: LMFT
Phone: 505-401-6615