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General NPI Number Information
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NPI Number | 1427857457
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Entity Type | Organization
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Legal Business Name | INCLUSIVE&EMPOWERING LIVING HOMES LLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 7519 VIA COMETA SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87121-6326
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Country | US
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Telephone | 505-353-1153
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Fax |
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Provider Business Mailing Address
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Address Line | 11812 BADGER MOUNTAIN TRL NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-4366
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Country | US
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Telephone | 505-353-1153
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ERIC NDAHEBA
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Credential |
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Telephone | 505-353-1153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/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 | 261QC1500X
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Taxonomy Name | Community Health 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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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