Organization
MENDING HEARTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKA PERALTA LCSW (OWNER)
(505) 903-5437
Entity
Organization
Contact information
Practice address
3939 SAN PEDRO DR NE BLDG B1, ALBUQUERQUE, NM 87110-8903
(505) 440-7600
(505) 344-2104
Mailing address
1305 SAN LORENZO AVE NW, ALBUQUERQUE, NM 87107-3427
(505) 903-5437
(505) 344-2104
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-09284
NM
Other
Enumeration date
08/31/2016
Last updated
08/01/2024
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