| Lifesphere Llc | |
|
532 Don Gaspar Ave Santa Fe NM 87505-2626 | |
| (505) 983-0693 | |
| (505) 393-3070 |
| Full Name | Lifesphere Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 532 Don Gaspar Ave, Santa Fe, New Mexico |
| Authorized Official Name and Position | Adonata Pyaga (MANAGER) |
| Authorized Official Contact | 5059830693 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesphere Llc 5 Bisbee Ct Ste 109 Santa Fe NM 87508-1419 Ph: (505) 983-0693 | Lifesphere Llc 532 Don Gaspar Ave Santa Fe NM 87505-2626 Ph: (505) 983-0693 |
| NPI Number | 1114509437 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 01/26/2024 |
| Certification Date | 01/26/2024 |
| Medicare PECOS PAC ID | 6204279029 |
|---|---|
| Medicare Enrollment ID | O20240208003316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114509437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Adonata Pyaga |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710495940 PECOS PAC ID: 7012350838 Enrollment ID: I20240208003380 |
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