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General NPI Number Information
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NPI Number | 1760421168
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Entity Type | Organization
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Legal Business Name | GUIDANCE FOUNDATION INC
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 08/10/2012
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Provider Practice Location Address
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Address Line | 4101 BARBARA LOOP SE SUITE D
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City | RIO RANCHO
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State | NM
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Zip | 87124-1009
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Country | US
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Telephone | 505-892-3639
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Fax | 505-892-6348
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Provider Business Mailing Address
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Address Line | 4101 BARBARA LOOP SE SUITE D
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City | RIO RANCHO
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State | NM
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Zip | 87124-1009
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Country | US
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Telephone | 505-892-3639
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Fax | 505-892-6348
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANICE MARION PENN
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Credential | PHD
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Telephone | 505-892-3639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | R14768
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License Number State | NM
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