Provider Demographics
NPI:1942779137
Name:SAM'S WISHES INC
Entity Type:Organization
Organization Name:SAM'S WISHES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:SUEHR
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-948-1811
Mailing Address - Street 1:5808 TIERRA ANTIGUA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7025
Mailing Address - Country:US
Mailing Address - Phone:505-948-1811
Mailing Address - Fax:505-544-4605
Practice Address - Street 1:5808 TIERRA ANTIGUA ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-7025
Practice Address - Country:US
Practice Address - Phone:505-948-1811
Practice Address - Fax:505-544-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health