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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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