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General NPI Number Information
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NPI Number | 1346565504
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Entity Type | Organization
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Legal Business Name | SANTA FE ZEN
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 127 EAST GATE DR STE 212F
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City | LOS ALAMOS
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State | NM
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Zip | 87544-3318
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Country | US
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Telephone | 505-216-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 2210 MIGUEL CHAVEZ RD # 1612
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City | SANTA FE
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State | NM
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Zip | 87505-6923
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Country | US
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Telephone | 505-660-8993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BARBARA LEE CZINGER
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Credential | LISW, LADAC
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Telephone | 505-660-8993
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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 | I-06046
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License Number State | NM
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