Provider Demographics
NPI:1437593316
Name:BREATH OF MY HEART
Entity type:Organization
Organization Name:BREATH OF MY HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEIXINHO
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:505-927-5558
Mailing Address - Street 1:705 LA JOYA ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-2235
Mailing Address - Country:US
Mailing Address - Phone:505-753-0505
Mailing Address - Fax:505-212-0420
Practice Address - Street 1:705 LA JOYA ST
Practice Address - Street 2:SUITE A
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2235
Practice Address - Country:US
Practice Address - Phone:505-753-0505
Practice Address - Fax:505-212-0420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03455R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Multi-Specialty