# PAINTED SKY THERAPY LLC

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

## Provider details

- **NPI number:** 1750970893
- **Authorized official:** BEBE MAKENA OTR/L (OWNER/OCCUPATIONAL THERAPIST)
- **Authorized official phone:** (575) 779-5319

## Contact information

- **Practice address:** 428 THEODORA ST, TAOS, NM 87571-6396
- **Practice address phone:** (575) 779-5319
- **Mailing address:** 1103 PASEO DEL PUEBLO NORTE \# 114, EL PRADO, NM 87529-7539
- **Mailing address phone:** (575) 779-5319

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/13/2021
- **Last updated:** 01/13/2021