Organization
TRAUMA TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLENE BUNCH LPCC (OWNER)
(505) 289-1042
Entity
Organization
Contact information
Practice address
1316 JACKIE RD SE STE 900, RIO RANCHO, NM 87124-6612
(505) 289-1042
(505) 466-5895
Mailing address
1316 JACKIE RD SE STE 900, RIO RANCHO, NM 87124-6612
(505) 289-1042
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225X00000X
Occupational Therapist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
0185071
NM
Other
Enumeration date
09/21/2017
Last updated
04/04/2019
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