Organization
HGU ENTERPRISES, LLC
Active
Other names
We Rock the Spectrum Kid's Gym, Westside ABQ
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COURTNEY ANNE LEWIS MA LPCC (CEO)
(505) 410-9548
Entity
Organization
Contact information
Practice address
1101 GOLF COURSE RD SE STE 103, RIO RANCHO, NM 87124-4732
(505) 410-9548
Mailing address
1101 GOLF COURSE RD SE STE 103, RIO RANCHO, NM 87124-4732
(505) 410-9548
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
—
—
385H00000X
Respite Care
—
—
385HR2050X
Respite Care Camp
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407350648
—
NM
05
—
1467472191
—
NM
Enumeration date
03/05/2024
Last updated
03/05/2024
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