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General NPI Number Information
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NPI Number | 1194912881
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Entity Type | Organization
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Legal Business Name | ENGENDER, INC
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 6749 ACADEMY RD NE STE D
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3375
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Country | US
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Telephone | 505-242-4400
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Fax | 505-242-4595
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Provider Business Mailing Address
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Address Line | 6749 ACADEMY RD NE STE D
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3375
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Country | US
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Telephone | 505-242-4400
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Fax | 505-242-4595
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Authorized Official
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Title or Position | CEO
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Name | DEBORAH PATRICK
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Credential |
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Telephone | 505-242-4400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 03082439007
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License Number State | NM
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