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General NPI Number Information
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NPI Number | 1588074926
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Entity Type | Organization
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Legal Business Name | LANI SOLUTIONS, LLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 2795 VIA CABALLERO DEL SUR
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City | SANTA FE
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State | NM
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Zip | 87505-5333
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Country | US
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Telephone | 505-699-9762
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Fax | 505-780-5123
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Provider Business Mailing Address
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Address Line | 2795 VIA CABALLERO DEL SUR
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City | SANTA FE
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State | NM
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Zip | 87505-5333
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Country | US
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Telephone | 505-699-9762
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Fax | 505-780-5123
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Authorized Official
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Title or Position | OWNER
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Name | ELSA BACKSTROM
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Credential | MA, LPCC
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Telephone | 505-699-9762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0141331
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License Number State | NM
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