Organization
THE COUPLE AND FAMILY THERAPY CENTER OF NEW MEXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA GATELY LMFT (OWNER)
(505) 414-3883
Entity
Organization
Contact information
Practice address
4010 CARLISLE BLVD NE STE G, ALBUQUERQUE, NM 87107-4532
(505) 414-3883
Mailing address
PO BOX 10762, ALBUQUERQUE, NM 87184-0762
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
03303958005
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89522711
—
NM
Enumeration date
10/27/2014
Last updated
10/29/2014
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