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Organization

LIFE RE-CREATED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CATHRYN ANA GLENDAY MPH MA LPCC (OWNER)
(505) 369-6756
Entity
Organization

Contact information

Practice address
3939 SAN PEDRO DR. NE, BLD C, STE 8, ALBUQUERQUE, NM 87110
(505) 369-6756
(505) 393-5201
Mailing address
PO BOX 8946, C/O CATHRYN GLENDAY, ALBUQUERQUE, NM 87198-8946
(505) 369-6756
(505) 393-5201

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9673365
NM
Enumeration date
06/21/2019
Last updated
07/18/2024
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