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General NPI Number Information
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NPI Number | 1275357162
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Entity Type | Organization
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Legal Business Name | HEART HEALING CENTER
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 6300 RIVERSIDE PLAZA LN NW STE 100
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1908
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Country | US
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Telephone | 505-750-0405
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Fax |
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Provider Business Mailing Address
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Address Line | 8001 AGUA FRIA CT NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-7055
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Country | US
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Telephone | 505-929-2242
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA PLEASE SELECT MOE
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Credential | LPCC
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Telephone | 505-929-2242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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