Organization
MANDALA GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA J SMITH LSW (OWNER)
(505) 859-0814
Entity
Organization
Contact information
Practice address
19478 HIGHWAY 314, BELEN, NM 87002-8223
(505) 859-0814
Mailing address
PO BOX 323, JARALES, NM 87023-0323
(505) 859-0814
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2010081
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70638
—
NM
Enumeration date
12/30/2013
Last updated
12/30/2013
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