Provider Demographics
NPI:1932917218
Name:BHAKTI HEART
Entity type:Organization
Organization Name:BHAKTI HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MCGONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-405-2337
Mailing Address - Street 1:1834 CAMINO LA CANADA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-5804
Mailing Address - Country:US
Mailing Address - Phone:575-405-2337
Mailing Address - Fax:
Practice Address - Street 1:1834 CAMINO LA CANADA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-5804
Practice Address - Country:US
Practice Address - Phone:575-405-2337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty