Provider Demographics
NPI:1427857457
Name:INCLUSIVE&EMPOWERING LIVING HOMES LLC
Entity type:Organization
Organization Name:INCLUSIVE&EMPOWERING LIVING HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:NDAHEBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-353-1153
Mailing Address - Street 1:11812 BADGER MOUNTAIN TRL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-4366
Mailing Address - Country:US
Mailing Address - Phone:505-353-1153
Mailing Address - Fax:
Practice Address - Street 1:7519 VIA COMETA SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-6326
Practice Address - Country:US
Practice Address - Phone:505-353-1153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health