Provider Demographics
NPI:1558136077
Name:THE AFFIRMARY, LLC
Entity Type:Organization
Organization Name:THE AFFIRMARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW-S
Authorized Official - Phone:505-255-1615
Mailing Address - Street 1:6801 JEFFERSON ST NE
Mailing Address - Street 2:SUITE 150 PMB 3492
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-255-1615
Mailing Address - Fax:
Practice Address - Street 1:6801 JEFFERSON ST NE
Practice Address - Street 2:SUITE 150 PMB 3492
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-255-1615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-15
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty