INTERFAITH LEAP INC. NPI 1770960064

NPI Information

  • NPI: 1770960064
  • Provider Name: INTERFAITH LEAP, INC.
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Organization
  • Doing Business As: SANGRE DE CRISTO CENTER
  • Address: 816 HIGHWAY 22
    PENA BLANCA, NM
    ZIP 87041
  • Phone: (505) 470-2887

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NPI Details

INTERFAITH LEAP, INC. is an addiction (substance use disorder) counselor in Pena Blanca, NM. INTERFAITH LEAP, INC. NPI is 1770960064. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sangre De Cristo Center.

The provider's business location address is:

816 HIGHWAY 22
PENA BLANCA, NM
ZIP 87041
Phone: (505) 470-2887

The provider's authorized official is Lawrence A Medina .
The authorized official title is Executive Director and has the following contact phone number (505) 470-2887.

The enumeration date for this NPI number is 5/6/2015 and was last updated on 7/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

What is NPI?

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This page was last updated on: 11/21/2025

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