Organization
HEART BRAIN INTERNATIONAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ZIMPELMAN MBR (REGISTERED AGENT)
(505) 933-5301
Entity
Organization
Contact information
Practice address
3228 LOS ARBOLES AVE NE # A-200, ALBUQUERQUE, NM 87107-1962
(505) 933-5301
Mailing address
1312 SIERRA LARGA DR. NE, ALBUQUERQUE, NM 87112
(505) 933-5301
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
102651
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12554677
CAQH
NM
05
—
96851287
—
NM
Enumeration date
09/11/2015
Last updated
09/14/2015
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