Organization
LIFE CHANGE INSTITUTE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNON ENRIGHT-SMITH LISW (FOUNDER/OWNER)
(505) 280-5860
Entity
Organization
Contact information
Practice address
9301 INDIAN SCHOOL RD NE STE 103, ALBUQUERQUE, NM 87112-2861
(505) 280-5860
(505) 294-3904
Mailing address
9301 INDIAN SCHOOL RD NE STE 103, ALBUQUERQUE, NM 87112-2861
(505) 280-5860
(505) 294-3904
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
I-06858
NM
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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