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General NPI Number Information
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NPI Number | 1811787781
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Entity Type | Organization
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Legal Business Name | ENSEMBLE OF ALBUQUERQUE, LLC
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 8725 ALAMEDA PARK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2475
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Country | US
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Telephone | 505-384-8374
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Fax |
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Provider Business Mailing Address
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Address Line | 8725 ALAMEDA PARK DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2475
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Country | US
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Telephone | 505-384-8374
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Fax |
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Authorized Official
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Title or Position | CIO
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Name | REYNOLD BUNZEL
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Credential |
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Telephone | 505-726-4152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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