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General NPI Number Information
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NPI Number | 1447902192
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Entity Type | Organization
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Legal Business Name | MAKING AN IMPACT LLC
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 2501 MONTERREY RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-5600
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Country | US
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Telephone | 719-651-7584
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Fax |
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Provider Business Mailing Address
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Address Line | 8601 GOLF COURSE RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5775
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Country | US
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Telephone | 719-651-7584
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Fax |
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Authorized Official
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Title or Position | VP
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Name | BROOKE SGUARDO
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Credential |
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Telephone | 480-299-2385
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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