Healthcare Provider Details

I. General information

NPI: 1609713775
Provider Name (Legal Business Name): COURAGE FULL SPECTRUM DOULA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 FEATHER CATCHER
SANTA FE NM
87506-2698
US

IV. Provider business mailing address

72 FEATHER CATCHER
SANTA FE NM
87506-2698
US

V. Phone/Fax

Practice location:
  • Phone: 505-470-0896
  • Fax:
Mailing address:
  • Phone: 575-425-0524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: AAMUNYTAS MAIRE
Title or Position: DOULA
Credential:
Phone: 575-425-0524