| La Buena Vida, Inc. - Los Lunas Office | |
|
303 Luna St Se Los Lunas NM 87031-9277 | |
| (505) 565-1619 | |
| (505) 565-1620 |
| Full Name | La Buena Vida, Inc. - Los Lunas Office |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 303 Luna St Se, Los Lunas, New Mexico |
| Authorized Official Name and Position | Kirsten M. Choubard (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5058672383 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Buena Vida, Inc. - Los Lunas Office 303 Luna St Se Los Lunas NM 87031-9277 Ph: (505) 565-1619 | La Buena Vida, Inc. - Los Lunas Office 303 Luna St Se Los Lunas NM 87031-9277 Ph: (505) 565-1619 |
| NPI Number | 1578728705 |
|---|---|
| Provider Enumeration Date | 07/28/2008 |
| Last Update Date | 07/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578728705 | NPI | - | NPPES |
| E7034 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 3043 (New Mexico) | Primary |
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