Organization
SPECIAL CONCERNS OF WOMEN AND CHILDREN
Active
Other names
Livingwell
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MINTIE (OWNER)
(505) 792-4519
Entity
Organization
Contact information
Practice address
312 WAYNE RD NW, LOS RANCHOS, NM 87114-1028
(505) 792-4519
Mailing address
312 WAYNE RD NW, LOS RANCHOS, NM 87114-1028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06493
NM
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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