Proud Moments Aba
Community/Behavioral Health in Albuquerque, NM. Organization (NPI-2).
NPI number1477465425
StatusActive
Last updated in NPPESSep 22, 2026
Details
- NPI
- 1477465425
- Entity type
- Organization (NPI-2)
- Legal business name
- Proud Moments Aba
- Organization subpart
- No
- Enumeration date
- Sep 22, 2026
- Certification date
- Sep 22, 2026
- Last updated
- Sep 22, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | – | – | Yes |
Practice location
10511 Golf Course Rd Nw Ste 103Albuquerque, NM 87114-5917
Phone 505-856-6880
Mailing address
10511 Golf Course Rd Nw Ste 103Albuquerque, NM 87114-5917
Phone 505-856-6880
Authorized official
Barbara Tisdale
Recruiter
7182155311
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All 388 Community/Behavioral Health Agency providers in Albuquerque · All 29,333 providers in Albuquerque
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