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General NPI Number Information
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NPI Number | 1780125989
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Entity Type | Organization
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Legal Business Name | RIO RANCHO FAMILY COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 333 RIO RANCHO DR NE STE 205
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City | RIO RANCHO
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State | NM
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Zip | 87124-1456
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Country | US
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Telephone | 505-814-1460
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 MONTERREY RD NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-1599
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Country | US
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Telephone | 505-814-1460
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Fax | 505-985-7433
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NATALIE CHAVEZ
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Credential |
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Telephone | 505-814-1460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0145701
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License Number State | NM
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