NPIMap

Organization Active NPI

La Buena Vida, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Los Lunas, NM
National Provider Identifier
1578728705
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
303 Luna St SE
Los Lunas, NM 87031-9277
Phone
(505) 565-1619
Fax
(505) 565-1620
NPI assigned
Jul 28, 2008
Organization subpart
Yes
Parent organization
LA BUENA VIDA, INC.As reported in NPPES

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
Ms. Kirsten M. Choubard, LISW
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

303 Luna St SE
Los Lunas, NM 87031-9277

Mailing address

303 Luna St SE
Los Lunas, NM 87031-9277
Phone (505) 565-1619

Other identifiers 1

IdentifierTypeStateIssuer
E7034MedicaidNM

Other names 1

  • La Buena Vida, Inc. - Los Lunas Office Other name

National Provider Directory

National Provider Directory
Tax ID family
La Buena Vida Inc2 organizations share this tax ID, including this one
Part of
La Buena Vida Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

303 Luna Ave SE
Los Lunas, NM 87031

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1578728705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 LUNA ST SE",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870319277",
            "telephone_number": "505-565-1619",
            "fax_number": "505-565-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 LUNA ST SE",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870319277",
            "telephone_number": "505-565-1619",
            "fax_number": "505-565-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA BUENA VIDA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LA BUENA VIDA, INC.",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "CHOUBARD",
        "authorized_official_first_name": "KIRSTEN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "505-867-2383",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LISW"
    },
    "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": [
        {
            "organization_name": "La Buena Vida, Inc. - Los Lunas Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Los Lunas, 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.