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General NPI Number Information
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NPI Number | 1790239986
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Entity Type | Organization
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Legal Business Name | NAMASTE FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 08/05/2016
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Last Update Date | 08/05/2016
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Provider Practice Location Address
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Address Line | 2320 GRANDE BLVD SE STE. C
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City | RIO RANCHO
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State | NM
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Zip | 87124-1653
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Country | US
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Telephone | 505-994-4959
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290
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City | CORRALES
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State | NM
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Zip | 87048-0290
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Country | US
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Telephone | 505-994-4959
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. REBECCA ELISABETH COLLA
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Credential | LPCC
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Telephone | 505-994-4959
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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 |
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License Number State |
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