Organization
DARRIN'S PLACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY LYMBURNER (MEMBER)
(727) 403-7847
Entity
Organization
Contact information
Practice address
720 E HACIENDA ST, ESPANOLA, NM 87532-2523
(727) 403-7847
Mailing address
530B HARKLE RD STE 100, SANTA FE, NM 87505-4739
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
11/16/2019
Last updated
11/16/2019
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