# ENCHANTMENT LEGACY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306232038
- **Authorized official:** MRS. THERESA L. MUTH (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (505) 384-3032

## Contact information

- **Practice address:** 514 WILLIAMS AVE, ESTANCIA, NM 87016-0697
- **Practice address phone:** (505) 384-3032
- **Practice address fax:** (505) 384-3033
- **Mailing address:** PO BOX 697, ESTANCIA, NM 87016-0697
- **Mailing address phone:** (505) 384-3032
- **Mailing address fax:** (505) 384-3033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | 172V00000X | NM | Yes |

## Other

- **Enumeration date:** 04/09/2015
- **Last updated:** 04/09/2015