Organization
NEW MEXICO CENTER FOR EMPOWERMENT AND MOOD SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW R DUBACH LCSW (OWNER/LICENSED CLINICAL SOCIAL WORK)
(505) 401-0520
Entity
Organization
Contact information
Practice address
11930 MENAUL BLVD NE STE 220A, ALBUQUERQUE, NM 87112-2461
(505) 401-0520
Mailing address
530B HARKLE RD # 100, SANTA FE, NM 87505-4739
(505) 401-0520
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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