Provider Demographics
NPI:1568790426
Name:AWAKE AND AWARE, LLC
Entity Type:Organization
Organization Name:AWAKE AND AWARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:505-573-0438
Mailing Address - Street 1:201 HERMOSA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1023
Mailing Address - Country:US
Mailing Address - Phone:505-573-0438
Mailing Address - Fax:
Practice Address - Street 1:201 HERMOSA DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1023
Practice Address - Country:US
Practice Address - Phone:505-573-0438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-067561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty