LIFE RE-CREATED LLC (NPI# 1033770904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033770904 |
| Entity Type | Organization |
| Organization Name | LIFE RE-CREATED LLC |
| Practice Address |
3939 San Pedro Dr. Ne Bld C, Ste 8 Albuquerque NM 87110 |
| Mailing Address |
Po Box 8946 C/o Cathryn Glenday Albuquerque NM 87198-8946 |
| Practice Telephone | 5053696756 |
| Practice Fax Number | 5053935201 |
| Mailing Telephone | 5053696756 |
| Mailing Fax Number | 5053935201 |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |
| Authorized Official Name | CATHRYN ANA GLENDAY (OWNER) |
| Authorized Official Telephone | 5053696756 |
| Authorized Official Credential | MPH MA LPCC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 9673365 | 05 |
| Street Address |
3939 SAN PEDRO DR. NE BLD C, STE 8 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| 1417472192 | Fnch Outpatient Services | Clinic/Center | 634 Manzano Street Ne, Albuquerque, NM 87110 | 2017-08-03 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003517 | Megan Aileen Rafferty | Counselor | 1564 Trujillo Rd. S.w., Albuquerque, NM 87105-2857 | 2020-11-02 |
| 1851901243 | David A Weichbrodt LLC | Counselor | 9412 Las Calabazillas Rd Ne, Albuquerque, NM 87111-2540 | 2020-07-31 |
| 1568080042 | Cyd Davis-hubler LLC | Counselor | 9301 Indian School Rd Ne Ste 200f, Albuquerque, NM 87112-2884 | 2020-07-10 |
| 1568089225 | Wild Rose Healing LLC | Counselor | 4012 Comanche Rd Ne, Albuquerque, NM 87110-1081 | 2020-06-29 |
| 1285267807 | Rickey Martin Apodaca | Counselor | 1 University of New Mexico # 63870, Albuquerque, NM 87131-0001 | 2020-02-21 |
| 1063045250 | You Matter Counseling Services, LLC | Counselor | 9768 Summer Shower Pl Nw, Albuquerque, NM 87120-4195 | 2020-02-17 |
| 1891331773 | Head To Toe Wellness, LLC | Counselor | 4619 Greene Ave, Suite D, Albuquerque, NM 87114 | 2019-11-26 |
| 1639713316 | Mary Lynn Griffin | Counselor | 6401 Bosque Meadows Pl Nw, Albuquerque, NM 87120-8802 | 2019-11-05 |
| 1710534375 | Tender Presence Counseling LLC | Counselor | 2929 Coors Blvd Nw Ste 307c, Albuquerque, NM 87120-1173 | 2019-08-19 |
| 1194387449 | Karen Sue Stockham | Counselor | 9024 Aspen Ave Ne, Albuquerque, NM 87112 | 2019-07-07 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
Please comment or provide details below to improve the information on LIFE RE-CREATED LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.