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General NPI Number Information
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NPI Number | 1518328046
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Entity Type | Organization
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Legal Business Name | ANDRE ARMENTA GRIEF & HEALING CENTER, LLC
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 03/11/2016
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Provider Practice Location Address
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Address Line | 6300 RIVERSIDE PLAZA LN NW SUITE 125
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2617
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Country | US
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Telephone | 505-796-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 6300 RIVERSIDE PLAZA LN NW SUITE 125
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-2617
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Country | US
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Telephone | 505-796-9600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DENISE CHRISTINE ARMENTA
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Credential | LISW
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Telephone | 505-263-2947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C-06137
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License Number State | NM
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