| Enchanting Skies Healing Llc | |
|
120 Aliso Dr Se Ste G Albuquerque NM 87108-2693 | |
| (412) 716-3139 | |
| Not Available |
| Full Name | Enchanting Skies Healing Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 120 Aliso Dr Se Ste G, Albuquerque, New Mexico |
| Authorized Official Name and Position | Diane Dahm (OWNER) |
| Authorized Official Contact | 4127163139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Enchanting Skies Healing Llc 10700 Academy Rd Ne Apt 2623 Albuquerque NM 87111-7340 Ph: (412) 716-3139 | Enchanting Skies Healing Llc 120 Aliso Dr Se Ste G Albuquerque NM 87108-2693 Ph: (412) 716-3139 |
| NPI Number | 1588435275 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 06/25/2024 |
| Certification Date | 06/25/2024 |
| Medicare PECOS PAC ID | 9133666308 |
|---|---|
| Medicare Enrollment ID | O20240806000947 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588435275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Diane Dahm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265752950 PECOS PAC ID: 8820346489 Enrollment ID: I20240806001078 |
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