Provider Demographics
NPI:1619369782
Name:SARAH E RIELAND, LLC
Entity Type:Organization
Organization Name:SARAH E RIELAND, LLC
Other - Org Name:SARAH E RIELAND, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:RIELAND
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-681-0246
Mailing Address - Street 1:3901 GEORGIA ST NE
Mailing Address - Street 2:SUITE A4
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1359
Mailing Address - Country:US
Mailing Address - Phone:505-681-0246
Mailing Address - Fax:505-681-0246
Practice Address - Street 1:3901 GEORGIA ST NE
Practice Address - Street 2:SUITE A4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1359
Practice Address - Country:US
Practice Address - Phone:505-681-0246
Practice Address - Fax:505-681-0246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0169511251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health