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Organization

HOZHO CENTER FOR PERSONAL ENHANCEMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEN COLLINS (EXECUTIVE DIRECTOR)
(505) 330-1885
Entity
Organization

Contact information

Practice address
2915 W HISTORIC HWY 66 ROOM 1203, GALLUP, NM 87301
(505) 870-1483
(505) 870-1483
Mailing address
PO BOX 3809, GALLUP, NM 87305-9998
(505) 330-1885
(505) 870-1483

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0180441
NM
104100000X
Social Worker
M-0777
NM
251S00000X
Community/Behavioral Health Agency
Primary
486
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
34359834
NM
Enumeration date
04/19/2016
Last updated
11/20/2023
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