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Contact Information

IDEAL SELF THERAPY LLC
720 8TH ST NE
RIO RANCHO, NM87124-0791
 Phone: 505-226-2191
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for IDEAL SELF THERAPY LLC

NPI # 1386447936
LBN Legal business name IDEAL SELF THERAPY LLC
Authorized official LEAH BOGUSCH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/29/2025
Last updated 03/29/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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