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Organization

METTA BHAVANA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEVIN JAMES COOGAN LCSW (OWNDER)
(505) 231-6658
Entity
Organization

Contact information

Practice address
1328 BISHOPS LODGE RD, SANTA FE, NM 87506-0002
(608) 561-7533
Mailing address
1328 BISHOPS LODGE RD, SANTA FE, NM 87506-0002
(608) 561-7533

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1740762327
NATIONAL PLAN AND PROVIDER SYSTEM
WI
Enumeration date
07/29/2022
Last updated
03/16/2026
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