Organization
AMADA MOTHERHOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
XIMENA LICANO (OWNER)
(575) 652-2743
Entity
Organization
Contact information
Practice address
2201 SAINT FRANCIS CT, PORTALES, NM 88130-9381
(575) 652-2743
Mailing address
2201 SAINT FRANCIS CT, PORTALES, NM 88130-9381
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
07/07/2026
Last updated
07/14/2026
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