Spirit Of Hope, LLC
Clinic/Center, Adult Mental Health in Edgewood, NM. Organization (NPI-2).
NPI number1174282909
StatusActive
Last updated in NPPESJan 3, 2022
Details
- NPI
- 1174282909
- Entity type
- Organization (NPI-2)
- Legal business name
- Spirit Of Hope, LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2021
- Certification date
- Jan 3, 2022
- Last updated
- Jan 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – |
Practice location
1637 Old Us 66Edgewood, NM 87015
Phone 505-750-2743
Mailing address
Po Box 9Edgewood, NM 87015-0009
Phone 505-750-2743
Authorized official
Kara Shrader
Owner
5057502743
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