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Organization

BRAIN BALANCE LIFE BALANCE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIDA M GUFFEY REGISTERED NURSE (NURSE CASE MANAGER)
(505) 436-2347
Entity
Organization

Contact information

Practice address
719 W APACHE ST, FARMINGTON, NM 87401-5512
(505) 436-2347
(505) 278-8939
Mailing address
719 W APACHE ST, FARMINGTON, NM 87401-5512
(505) 436-2347
(505) 278-8939

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
07/26/2022
Last updated
07/26/2022
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