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Organization

LA BUENA VIDA, INC.

Active
Parent organization
LA BUENA VIDA, INC.
Other names
La Buena Vida, Inc. - Los Lunas Office
Organization subpart
Yes

Provider details

NPI number
Legal business name
LA BUENA VIDA, INC.
Authorized official
MS. KIRSTEN M. CHOUBARD LISW (EXECUTIVE DIRECTOR)
(505) 867-2383
Entity
Organization

Contact information

Practice address
303 LUNA ST SE, LOS LUNAS, NM 87031-9277
(505) 565-1619
(505) 565-1620
Mailing address
303 LUNA ST SE, LOS LUNAS, NM 87031-9277
(505) 565-1619
(505) 565-1620

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
3043
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
E7034
NM
Enumeration date
07/28/2008
Last updated
07/28/2008
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