Organization
RISE WOMENS SELF RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE PEIXINHO LMSW (THERAPIST)
(505) 484-9154
Entity
Organization
Contact information
Practice address
507 W PUEBLO DR, ESPANOLA, NM 87532-2508
(505) 484-9154
Mailing address
PO BOX 305, CHIMAYO, NM 87522-0305
(505) 484-9154
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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