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General NPI Number Information
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NPI Number | 1386339786
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Entity Type | Organization
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Legal Business Name | POSITIVE VIBES INC
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 4004 CARLISLE BLVD NE STE P
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-4544
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Country | US
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Telephone | 505-923-0008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 53553
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City | ALBUQUERQUE
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State | NM
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Zip | 87153-3553
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Country | US
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Telephone | 505-923-0008
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | STELLA L LOPEZ
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Credential | LCSW
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Telephone | 505-923-0008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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