NPIMap

Organization Active NPI

La Buena Vida, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bernalillo, NM
National Provider Identifier
1386676856
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
3043 Issued in NM
Legal business name
LA BUENA VIDA, INC.
Practice address
872 Camino del Pueblo
Bernalillo, NM 87004
Phone
(505) 867-2383
Fax
(505) 867-7293
NPI assigned
Jul 7, 2006
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kirsten Marie Choubard, MSW, LPCC
Title
Executive Director
Phone
(505) 867-2383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 3043 NM Primary

Addresses

Primary practice location

872 Camino del Pueblo
Bernalillo, NM 87004

Mailing address

PO Box 1147
Bernalillo, NM 87004-1147
Phone (505) 867-2383

Other identifiers 1

IdentifierTypeStateIssuer
E7034MedicaidNM

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1386676856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1147",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "870041147",
            "telephone_number": "505-867-2383",
            "fax_number": "505-867-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 CAMINO DEL PUEBLO",
            "city": "BERNALILLO",
            "state": "NM",
            "postal_code": "87004",
            "telephone_number": "505-867-2383",
            "fax_number": "505-867-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA BUENA VIDA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "CHOUBARD",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-867-2383",
        "authorized_official_credential": "MSW, LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NM",
            "license": "3043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E7034",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bernalillo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.