Organization Name: | MANDALA GROUP INC. |
NPI Number: | 1376964841 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARBARA J SMITH (OWNER) |
Mailing Address: | 19478 Highway 314 Belen |
State: | NM US |
Postal Code: | 870028223 |
Phone Number: | 5058590814 |
Fax Number: | |
NPI Enumeration Date: | 12/30/2013 |
NPI Last Update Date: | 12/30/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 2010081 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |