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General NPI Number Information
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NPI Number | 1558252114
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Entity Type | Organization
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Legal Business Name | RAICES HEALING CENTER LLC
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 6503 2ND ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-6002
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Country | US
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Telephone | 623-419-2997
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Fax |
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Provider Business Mailing Address
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Address Line | 6503 2ND ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-6002
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Country | US
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Telephone | 623-419-2997
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MS. YESENIA ALVARADO HUERIGO
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Credential |
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Telephone | 623-419-2997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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