| Organization Name: | ENCHANTMENT LEGACY, INC. |
| NPI Number: | 1306232038 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | THERESA L. MUTH (EXECUTIVE DIRECTOR) |
| Mailing Address: | 514 Williams Ave Estancia |
| State: | NM US |
| Postal Code: | 870160697 |
| Phone Number: | 5053843032 |
| Fax Number: | 5053843033 |
| NPI Enumeration Date: | 04/09/2015 |
| NPI Last Update Date: | 04/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 253Z00000X |
| License Number: | 172V00000X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | In Home Supportive Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |