Organization Active NPI

Enchanting Skies Healing LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
National Provider Identifier
1588435275
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ENCHANTING SKIES HEALING LLC
Practice address
120 Aliso Dr SE Ste G
Albuquerque, NM 87108-2693
Phone
(412) 716-3139
NPI assigned
Jan 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Diane Dahm, LCSWNPI 1265752950
Title
Owner
Phone
(412) 716-3139

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

120 Aliso Dr SE Ste G
Albuquerque, NM 87108-2693

Mailing address

10700 Academy Rd NE Apt 2623
Albuquerque, NM 87111-7340
Phone (412) 716-3139

Other practice location 1

8372 Highway 4 Apt 2623
Jemez Pueblo, NM 87024-9727
Phone (412) 716-3139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240806000947 NM Part B Supplier - Clinic/Group Practice 9133666308 Receives reassigned benefits from 1 practitioner
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

8372 Highway 4
Apt 2623
Jemez Pueblo, NM 87024
Phone (412) 716-3139

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1588435275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 ACADEMY RD NE APT 2623",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117340",
            "telephone_number": "412-716-3139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 ALISO DR SE STE G",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082693",
            "telephone_number": "412-716-3139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8372 Highway 4 Apt 2623",
            "address_purpose": "LOCATION",
            "city": "Jemez Pueblo",
            "state": "NM",
            "postal_code": "870249727",
            "country_code": "US",
            "telephone_number": "412-716-3139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ENCHANTING SKIES HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "DAHM",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-716-3139",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.