Organization
ENCHANTED HEALING OF NEW MEXICO LLC
Active
Organization
ENCHANTED HEALING OF NEW MEXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELASARIA LIHON LISW (OWNER)
(505) 362-5847
Entity
Organization
Contact information
Practice address
21 KUHN DR, TIJERAS, NM 87059-8101
(505) 362-5847
Mailing address
PO BOX 23, JEMEZ SPRINGS, NM 87025-0023
(505) 362-5847
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
I-06142
NM
101YP1600X
Pastoral Counselor
I-06142
NM
1041C0700X
Clinical Social Worker
Primary
I-06142
NM
Other
Enumeration date
05/05/2010
Last updated
05/05/2010
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