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General NPI Number Information
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NPI Number | 1053247528
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Entity Type | Organization
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Legal Business Name | YUCA VIDA INC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 1420 S 8TH ST
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City | DEMING
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State | NM
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Zip | 88030-4903
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Country | US
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Telephone | 575-332-1312
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 S MESILLA ST
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City | DEMING
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State | NM
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Zip | 88030-4944
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Country | US
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Telephone | 575-332-1312
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LIDIA VEGA CHAVIRA
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Credential | LADAC, LMSW, CPSW
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Telephone | 575-332-1312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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